Individual
DR. AUSTEN DANIEL SLADE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
8854 W EMERALD ST STE 140, BOISE, ID 83704-4845
(208) 321-4790
Mailing address
8854 W EMERALD ST STE 140, BOISE, ID 83704-4845
(208) 321-4790
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
01085346A
IN
208800000X
Urology Physician
Primary
M-16995
ID
390200000X
Student in an Organized Health Care Education/Training Program
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—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300048897
—
IN
Enumeration date
04/05/2016
Last updated
03/19/2026
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