MICHAEL C SLACK (NPI# 1588758940) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1588758940 |
| Entity Type | Individual |
| Full Name | MICHAEL C SLACK |
| Credential | MD |
| Practice Address |
22 S Greene St N5w70c Baltimore MD 21201-1544 |
| Mailing Address |
Po Box 62063 Baltimore MD 21264-2063 |
| Practice Telephone | 4103282427 |
| Practice Fax Number | 4434623137 |
| Mailing Telephone | 4107065181 |
| Mailing Fax Number | 4107065103 |
| Enumeration Date | 2006-10-02 |
| Last Update Date | 2015-01-05 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2080P0202X |
Pediatrics Specialization: Pediatric Cardiology |
D55380 | MD | Allopathic & Osteopathic Physicians |
| N | 2080P0202X |
Pediatrics Specialization: Pediatric Cardiology |
MD31860 | DC | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| DC | 028095100 | 05 | |
| MD | 202009201 | 05 | |
| DC | CAREFIRST | 0614 | 01 |
| MD | 202009200 | 05 | |
| VA | 6731538 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679006076 | Michael Slack | Family Medicine | 5016 N Us Hwy 75, Denison, TX 75020 | 2017-04-04 |
| 1003394495 | Michael Andrew Slack | Physical Therapist | 1712 Owen Dr, Fayetteville, NC 28304-3419 | 2018-07-30 |
| 1245650217 | Michael Slack | Counselor | 5019 Grove St Ste 102, Marysville, WA 98270-4491 | 2014-04-17 |
| 1104939222 | Michael Byron Slack | Social Worker | 101 Bodin Cir, David Grant Medical Center, Travis Afb, CA 94535-1809 | 2006-08-15 |
| Street Address |
22 S GREENE ST N5W70C |
| City | BALTIMORE |
| State | MD |
| Zip Code | 21201-1544 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750383063 | Malinda Daniel Duke | Nurse Practitioner | 22 S Greene St, Rm N6w84, Baltimore, MD 21201-1544 | 2005-06-01 |
| 1891396784 | Tamara Wiseman | Nurse Practitioner | 22 S Greene St, Baltimore, MD 21201-1544 | 2020-11-05 |
| 1063012664 | Shawna Marie Hutton | Registered Nurse | 22 S Greene St, Baltimore, MD 21201-1590 | 2020-11-01 |
| 1124625413 | Kerry Ann Lambert | Pharmacist | 22 S Greene St, Baltimore, MD 21201-1590 | 2020-10-08 |
| 1730786104 | Joseph William Russo | Pediatrics | 22 S Greene St, Baltimore, MD 21201-1590 | 2020-10-07 |
| 1295342327 | Leah Marie Dubose | Nurse Practitioner | 22 S Greene St, Baltimore, MD 21201-1544 | 2020-09-23 |
| 1275147167 | Rosalynn Joy Allen | Registered Nurse | 22 S Greene St, Baltimore, MD 21201-1590 | 2020-09-08 |
| 1174137269 | Keiara Williams | Nurse Practitioner | 22 S Greene St, Baltimore, MD 21201-1544 | 2020-09-04 |
| 1699389858 | Caitlin Lauren Thomas | Nurse Practitioner | 22 S Greene St, Baltimore, MD 21201-1544 | 2020-09-04 |
| 1639782568 | Anna Pfouts | Nurse Practitioner | 22 S Greene St, Baltimore, MD 21201-1544 | 2020-08-29 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518585470 | Meshref Ayed Alshehri | Student in an Organized Health Care Education/Training Program | 22 S. Greene Street, Room N3e09, Baltimore, MD 21201 | 2020-07-08 |
| 1306462411 | Michael Julian Wong | Student in an Organized Health Care Education/Training Program | University of Maryland, Department of Anesthesiology, 22 S Green St, S11b, Baltimore, MD 21201 | 2020-06-24 |
| 1740817733 | Martha Kaitlyn Coghlan | Student in an Organized Health Care Education/Training Program | Ummc Ob/gyn, 22 S. Greene St., Baltimore, MD 21201 | 2020-03-27 |
| 1629606637 | Taylor Renee Kai | Student in an Organized Health Care Education/Training Program | University of Maryland, 22 S. Greene Street, Room N3e09, Baltimore, MD 21201 | 2020-03-27 |
| 1295362697 | Brittany A Oster | Student in an Organized Health Care Education/Training Program | 110 S. Paca Street 6th Floor, Suite 300, Baltimore, MD 21201 | 2020-03-25 |
| 1346877735 | Kayvon Michael Mobarakeh | Student in an Organized Health Care Education/Training Program | University of Maryland Department of Anesthesiology, 22 S Greene St, S11c, Baltimore, MD 21201 | 2020-03-25 |
| 1598392284 | Zachary Allan Hagen | Student in an Organized Health Care Education/Training Program | 110 S. Paca Street, 6th Flr., Suite 200, Baltimore, MD 21201 | 2020-03-24 |
| 1700430055 | Jaime Semchuk | Student in an Organized Health Care Education/Training Program | 737 West Lombard, Baltimore, MD 21201 | 2019-07-25 |
| 1952861619 | Zachary Daniel Sanford | Student in an Organized Health Care Education/Training Program | 22 S Greene Street S8b12, Baltimore, MD 21201 | 2019-03-20 |
| 1114487840 | Spencer Sykes Lovegrove | Student in an Organized Health Care Education/Training Program | 110 S. Paca Street, Sixth Floor, Suite 200, Baltimore, Sixth Floor, Suite 200, Baltimore, MD 21201 | 2019-03-20 |
| Find all providers in zip 21201 | ||||
| Taxonomy Code | 2080P0202X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| Specialization | Pediatric Cardiology |
| A pediatric cardiologist provides comprehensive care to patients with cardiovascular problems. This specialist is skilled in selecting, performing and evaluating the structural and functional assessment of the heart and blood vessels, and the clinical evaluation of cardiovascular disease. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) was provided by the American Osteopathic Board of Pediatrics. The Certification is no longer offered. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205094828 | Caridad Maylin Delauz | Pediatrics | 1800 Orleans St # M2319, Baltimore, MD 21287-0010 | 2008-05-30 |
| 1619942042 | Richard Elliot Ringel | Pediatrics | Johns Hopkins Hospital - Brady 508, 600 North Wolfe St, Baltimore, MD 21287-0001 | 2006-02-21 |
| 1902164239 | Benjamin Barnes | Pediatrics | 1800 Orleans St, Baltimore, MD 21287-0010 | 2012-04-24 |
| 1801181136 | Shari L Wellen | Pediatrics | 1800 Orleans St, Baltimore, MD 21287-0010 | 2011-06-15 |
| 1578797346 | Hannah Y Fraint | Pediatrics | 1800 Orleans St, Baltimore, MD 21287-0010 | 2009-05-08 |
| 1134336241 | Priya Sekar | Pediatrics | 600 N Wolfe St, Brady 5, Baltimore, MD 21287-0005 | 2007-05-17 |
| 1073725644 | Sinai Hospital of Baltimore | Pediatrics | 2401 W Belvedere Ave, Baltimore, MD 21215-5216 | 2007-05-04 |
| 1689798365 | Jennifer Pardo | Pediatrics | 600 N Wolfe St, Baltimore, MD 21287-0005 | 2007-03-19 |
| 1366588790 | Mark Evan Lindsay | Pediatrics | 600 N Wolfe St, Brady 5th Floor, Baltimore, MD 21287-0005 | 2007-01-30 |
| 1215092036 | Shelby Kutty | Pediatrics | 1800 Orleans St, Baltimore, MD 21287-0010 | 2006-12-22 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.