Provider Demographics
NPI:1063446748
Name:KAPLAN, MICHAEL SLATER (PHD, MD)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:SLATER
Last Name:KAPLAN
Suffix:
Gender:M
Credentials:PHD, MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:816 FREDERICK ROAD
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21228-4505
Mailing Address - Country:US
Mailing Address - Phone:410-744-5133
Mailing Address - Fax:410-788-1452
Practice Address - Street 1:816 FREDERICK ROAD
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21228-4505
Practice Address - Country:US
Practice Address - Phone:410-744-5133
Practice Address - Fax:410-788-1452
Is Sole Proprietor?:No
Enumeration Date:2006-07-10
Last Update Date:2010-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0038656174400000X, 208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD0004307240OtherAETNA
MD3171750OC02OtherUNITEDHEALTHCARE
MDKU48OtherGROUP NUMBER FOR BCBS
MDT45830002OtherBLUE CHOICE
MD42430701OtherBLUE CROSS BLUE SHIELD
MDKU48OtherGROUP NUMBER FOR BCBS
E17152Medicare UPIN