Provider Demographics
NPI:1922448703
Name:SLEMENDA, COLIN FITZGERALD (DO)
Entity type:Individual
Prefix:
First Name:COLIN
Middle Name:FITZGERALD
Last Name:SLEMENDA
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:575 COAL VALLEY RD STE 570
Mailing Address - Street 2:
Mailing Address - City:JEFFERSON HILLS
Mailing Address - State:PA
Mailing Address - Zip Code:15025-3729
Mailing Address - Country:US
Mailing Address - Phone:124-697-6604
Mailing Address - Fax:412-469-7547
Practice Address - Street 1:575 COAL VALLEY RD STE 570
Practice Address - Street 2:
Practice Address - City:JEFFERSON HILLS
Practice Address - State:PA
Practice Address - Zip Code:15025-3729
Practice Address - Country:US
Practice Address - Phone:412-697-6604
Practice Address - Fax:412-469-7547
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-26
Last Update Date:2024-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS020182207RC0000X, 207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional CardiologyGroup - Multi-Specialty
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA103241780Medicaid
PA1E0054OtherMEDICARE
PA6507387OtherAETNA PIN