Provider Demographics
NPI:1780624874
Name:SLAWSKI, DANIEL PAUL (MD)
Entity type:Individual
Prefix:
First Name:DANIEL
Middle Name:PAUL
Last Name:SLAWSKI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2810 W 35TH ST
Mailing Address - Street 2:
Mailing Address - City:KEARNEY
Mailing Address - State:NE
Mailing Address - Zip Code:68845-2909
Mailing Address - Country:US
Mailing Address - Phone:308-865-2570
Mailing Address - Fax:308-865-2508
Practice Address - Street 1:2810 W 35TH ST
Practice Address - Street 2:
Practice Address - City:KEARNEY
Practice Address - State:NE
Practice Address - Zip Code:68845-2909
Practice Address - Country:US
Practice Address - Phone:308-865-2570
Practice Address - Fax:308-865-2508
Is Sole Proprietor?:No
Enumeration Date:2006-06-07
Last Update Date:2014-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE19860207XX0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS200073240BMedicaid
NE00268OtherBCBS OF NEBRASKA
NE8493OtherMIDLANDS CHOICE
NE275203Medicare ID - Type Unspecified
NE8493OtherMIDLANDS CHOICE
KS200073240BMedicaid