Organization
DYLAN SLOTAR MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DYLAN SLOTAR MD (PHYSICIAN/PRESIDENT)
(219) 301-7265
Entity
Organization
Contact information
Practice address
9124 COLUMBIA AVE # B, MUNSTER, IN 46321-2907
(844) 450-3100
Mailing address
PO BOX 697, TINLEY PARK, IL 60477-0697
(219) 301-7265
Taxonomy
Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01062924A
IN MD LICENSE NUMBER
IN
Enumeration date
05/15/2019
Last updated
05/15/2019
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