Provider Demographics
NPI:1871872986
Name:SLOBOGEAN, MYRON GP (MD)
Entity type:Individual
Prefix:DR
First Name:MYRON
Middle Name:GP
Last Name:SLOBOGEAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:MYRON
Other - Middle Name:GP
Other - Last Name:SLOBOGEAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:22 S GREENE ST
Mailing Address - Street 2:DIVISION OF ORTHOPAEDIC TRAUMATOLOGY
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21201-1544
Mailing Address - Country:US
Mailing Address - Phone:410-328-6280
Mailing Address - Fax:410-328-6280
Practice Address - Street 1:22 S GREENE ST
Practice Address - Street 2:DIVISION OF ORTHOPAEDIC TRAUMATOLOGY
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21201-1544
Practice Address - Country:US
Practice Address - Phone:410-328-6280
Practice Address - Fax:410-328-6280
Is Sole Proprietor?:No
Enumeration Date:2011-08-07
Last Update Date:2015-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ZZ00000207XX0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XX0801XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Trauma