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Individual

DR. MICHAEL JOSEF SLIMACK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.O.

Contact information

Practice address
7401 104TH AVE, SUITE 110, KENOSHA, WI 53142-7845
(262) 764-5595
(262) 764-9314
Mailing address
7401 104TH AVE, SUITE 110, KENOSHA, WI 53142-7845
(262) 764-5595
(262) 764-9314

Taxonomy

Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
58000956
OH
207XS0114X
Adult Reconstructive Orthopaedic Surgery Physician
Primary
51760
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
37580900
WI
Enumeration date
05/17/2007
Last updated
03/18/2015
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