Individual
IAN FREDERICK SLACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
24 FRANK LLOYD WRIGHT DR, ANN ARBOR, MI 48105-9484
(734) 647-5940
Mailing address
3621 S STATE ST, ANN ARBOR, MI 48108-1633
(734) 647-5299
Taxonomy
Speciality
Code
Description
License number
State
207K00000X
Allergy & Immunology Physician
Primary
4301504878
MI
Other
Enumeration date
06/13/2016
Last updated
10/18/2022
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