Provider Demographics
NPI:1528252632
Name:MICHAEL A SLESS, O.D. P.A.
Entity type:Organization
Organization Name:MICHAEL A SLESS, O.D. P.A.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:ALAN
Authorized Official - Last Name:SLESS
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:410-343-2409
Mailing Address - Street 1:16940 YORK RD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:MONKTON
Mailing Address - State:MD
Mailing Address - Zip Code:21111-1095
Mailing Address - Country:US
Mailing Address - Phone:410-343-2409
Mailing Address - Fax:
Practice Address - Street 1:16940 YORK RD STE 200
Practice Address - Street 2:
Practice Address - City:MONKTON
Practice Address - State:MD
Practice Address - Zip Code:21111-1038
Practice Address - Country:US
Practice Address - Phone:410-343-2409
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-31
Last Update Date:2009-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDTA0896152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD0325620001Medicare NSC
MDXO36Medicare UPIN