Individual
BRENDA R SLAGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
5777 E MAYO BLVD, PHOENIX, AZ 85054-4502
(480) 301-8000
Mailing address
5777 E MAYO BLVD, PHOENIX, AZ 85054-4502
(480) 301-8000
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
1118
WI
363AM0700X
Medical Physician Assistant
Primary
3661
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
264057
—
AZ
05
—
42978400
—
WI
01
—
P00624740
RAILROAD MEDICARE
AZ
Enumeration date
04/03/2006
Last updated
10/31/2008
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