Individual
DAVID M. SLACK
Active
Individual
DAVID M. SLACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
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
Update your record
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