Doctor Name: | MR. SIMEON CHARLES SLAYTON |
NPI Number: | 1770833030 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MS |
License Number: | 2705 124382 |
Business Practice Address: | 10519 Godwin Dr Manassas, VA - 201122736 |
Business Phone Number: | 7034899300 |
Business Fax Number: | 7035300961 |
Mailing Address: | 10519 Godwin Dr, MANASSAS |
State: | VA |
Postal Code: | 201122736 |
Phone Number: | 7034899300 |
Fax Number: | 7035300961 |
NPI Enumeration Date: | 09/14/2012 |
NPI Last Update Date: | 09/14/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 332B00000X |
License Number: | 2705 124382 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | VA |
Taxonomy Type: | Suppliers |
Taxonomy Classification: | Durable Medical Equipment & Medical Supplies |
Taxonomy Specialization: | |
Taxonomy Definition: | A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient |