Individual
DAVID M. SLACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
179 NORTHAMPTON ST, #H, EASTHAMPTON, MA 01027-1057
(413) 529-9300
(413) 527-9793
Mailing address
PO BOX 8019, SPRINGFIELD, MA 01102-8000
(866) 431-4077
(413) 774-7448
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
72497
MA
208000000X
Pediatrics Physician
72497
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000007738
BOSTON MEDICAL CENTER HEALTHNET PLAN
MA
01
—
1024130
CIGNA
MA
01
—
1293916
FALLON
MA
01
—
16474
HEALTH NEW ENGLAND
MA
01
—
2358373
AETNA
MA
05
—
3066134
—
MA
01
—
63401
HARVARD PILGRIM
MA
01
—
729533
TUFTS
MA
01
—
740008
CONNECTICARE
MA
01
—
J09911
BCBSMA
MA
Enumeration date
03/23/2006
Last updated
06/17/2008
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