Provider Demographics
NPI:1427098656
Name:SLAMA, DAVID D (MD)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:D
Last Name:SLAMA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:717 SAINT FRANCIS ST
Mailing Address - Street 2:
Mailing Address - City:RAPID CITY
Mailing Address - State:SD
Mailing Address - Zip Code:57701-4677
Mailing Address - Country:US
Mailing Address - Phone:605-342-2880
Mailing Address - Fax:605-388-4621
Practice Address - Street 1:717 SAINT FRANCIS ST
Practice Address - Street 2:
Practice Address - City:RAPID CITY
Practice Address - State:SD
Practice Address - Zip Code:57701-4677
Practice Address - Country:US
Practice Address - Phone:605-342-2880
Practice Address - Fax:605-388-4621
Is Sole Proprietor?:No
Enumeration Date:2006-06-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD2191208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
SD7302100Medicaid
4994022OtherBCBS
SD7302100Medicaid
SD101040Medicare ID - Type Unspecified