Provider Demographics
NPI:1760131056
Name:SLACK, ABIGAIL LINDEMAN (MD)
Entity type:Individual
Prefix:
First Name:ABIGAIL
Middle Name:LINDEMAN
Last Name:SLACK
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1818 N OGDEN ST STE 300
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80218-1277
Mailing Address - Country:US
Mailing Address - Phone:303-830-7337
Mailing Address - Fax:
Practice Address - Street 1:1818 N OGDEN ST STE 300
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80218-1277
Practice Address - Country:US
Practice Address - Phone:303-830-7337
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-22
Last Update Date:2025-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CODR.0074854208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics