Provider Demographics
NPI:1588879597
Name:SLAMA-MCMANUS, KELLY A (MD)
Entity type:Individual
Prefix:
First Name:KELLY
Middle Name:A
Last Name:SLAMA-MCMANUS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4685 RELIABLE PKWY
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60686-0046
Mailing Address - Country:US
Mailing Address - Phone:317-802-3173
Mailing Address - Fax:317-870-0499
Practice Address - Street 1:2001 W 86TH ST
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46260-1902
Practice Address - Country:US
Practice Address - Phone:317-802-3173
Practice Address - Fax:317-870-0499
Is Sole Proprietor?:No
Enumeration Date:2007-05-12
Last Update Date:2013-01-07
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IN01063522A208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics