Individual
WILSON ROY SLAUNWHITE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
309 COUNTY ROUTE 47, SUITE 1, SARANAC LAKE, NY 12983-5405
(518) 891-2688
(518) 891-4120
Mailing address
309 COUNTY ROUTE 47, SUITE 1, SARANAC LAKE, NY 12983-5405
(518) 891-2688
(518) 891-4120
Taxonomy
Speciality
Code
Description
License number
State
207K00000X
Allergy & Immunology Physician
Primary
120898
NY
208000000X
Pediatrics Physician
120898
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000401496001
BLUE SHIELD NENY
NY
05
—
00459458
—
NY
01
—
1063412039
FIDELIS
NY
01
—
50E111
BLUE CROSS BLUE SHIELD
NY
01
—
DD2643
PALMETTO GBA
NY
01
—
P00000040501
GHI FHP
NY
Enumeration date
07/29/2005
Last updated
05/14/2008
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