Provider Demographics
NPI:1023169901
Name:SLOVAK, EMIL JR (MD)
Entity type:Individual
Prefix:
First Name:EMIL
Middle Name:
Last Name:SLOVAK
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:EMIL
Other - Middle Name:
Other - Last Name:SLOVAK
Other - Suffix:JR
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 188
Mailing Address - Street 2:
Mailing Address - City:MARANA
Mailing Address - State:AZ
Mailing Address - Zip Code:85653-0188
Mailing Address - Country:US
Mailing Address - Phone:520-682-4111
Mailing Address - Fax:520-616-1442
Practice Address - Street 1:5224 W DOVE CENTRE RD
Practice Address - Street 2:
Practice Address - City:MARANA
Practice Address - State:AZ
Practice Address - Zip Code:85658-5063
Practice Address - Country:US
Practice Address - Phone:520-616-1445
Practice Address - Fax:520-616-1446
Is Sole Proprietor?:No
Enumeration Date:2007-01-16
Last Update Date:2024-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ18420207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ063412Medicaid
AZ367745Medicaid
E76262Medicare UPIN
Z124995Medicare PIN
AZ063412Medicaid
Z90412Medicare PIN