Individual
JEANETTE K SLADICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
18101 OAKWOOD BLVD, TRAUMA SERVICES, DEARBORN, MI 48124-4089
(313) 982-5440
(313) 982-5445
Mailing address
26901 BEAUMONT BLVD STE 3D, SOUTHFIELD, MI 48033-3849
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
10112
MN
363A00000X
Physician Assistant
Primary
5601005370
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
416564100
—
MA
Enumeration date
07/27/2006
Last updated
10/07/2022
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