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Individual

DR. VENEZELA THOMAS SLADE-HARTMAN

Active
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Individual

DR. VENEZELA THOMAS SLADE-HARTMAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
200201189
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0102939
UNITED HEALTHCARE
NC
01
—
080190704
RAIL ROAD MEDICARE
NC
01
—
132TC
BCBS
NC
01
—
280161
MAMSI
NC
01
—
3024671
AETNA - HMO
NC
01
—
4517503001
CIGNA HEALTHCARE
NC
01
—
7035421
AETNA NON HMO
NC
01
—
801186
PARTNERS MEDICARE CHOICE
NC
05
—
89132TC
—
NC
01
—
B9795
MEDCOST
NY
Enumeration date
12/21/2005
Last updated
10/03/2013
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