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Organization
NORTHWOODS EAR, NOSE & THROAT PC
Active
Organization
NORTHWOODS EAR, NOSE & THROAT PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAMES J SLATER D.O. (OWNER)
(231) 348-5900
Entity
Organization
Contact information
Practice address
2611 CHARLEVOIX AVE, PETOSKEY, MI 49770-8524
(231) 348-5900
(231) 348-5901
Mailing address
2611 CHARLEVOIX AVE, PETOSKEY, MI 49770-8524
(231) 348-5900
(231) 348-5901
Taxonomy
Speciality
Code
Description
License number
State
207YS0123X
Facial Plastic Surgery Physician
Primary
5101015870
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1751601125
BCBS
MI
05
—
4832946-11
—
MI
Enumeration date
05/18/2006
Last updated
05/11/2012
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