Basic Information
| Provider Information | |||||||||
| NPI: | 1326032541 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SLICK | ||||||||
| FirstName: | GREGORY | ||||||||
| MiddleName: | D | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1086 FRANKLIN ST | ||||||||
| Address2: | |||||||||
| City: | JOHNSTOWN | ||||||||
| State: | PA | ||||||||
| PostalCode: | 159054305 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8145358885 | ||||||||
| FaxNumber: | 8145358720 | ||||||||
| Practice Location | |||||||||
| Address1: | 140 S ANDERSON ST | ||||||||
| Address2: | |||||||||
| City: | BEDFORD | ||||||||
| State: | PA | ||||||||
| PostalCode: | 155221403 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8146236917 | ||||||||
| FaxNumber: | 8146237520 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/02/2005 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | X | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | MD027746E | PA | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.