Individual
LAWRENCE J SLADICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
910 NW 16TH, FRUITLAND, ID 83619
(208) 452-8040
(208) 452-8056
Mailing address
3340 E GOLDSTONE WAY, MERIDIAN, ID 83642-1026
(208) 452-8040
(208) 452-8056
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
M5535
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003952400
—
ID
Enumeration date
06/17/2006
Last updated
11/09/2016
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