Individual
DR. VINCENT C SLATER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
120 HEYWOOD AVE, SPARTANBURG, SC 29302
(864) 573-9595
Mailing address
PO BOX 743070, ATLANTA, GA 30374-3070
(864) 560-4304
(864) 560-4413
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
1192
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
011926
—
SC
01
—
AA67634722
MEDICARE PIN
SC
01
—
AA67635019
MEDICARE PIN
SC
01
—
AA67636067
MEDICARE PIN
SC
01
—
AA67636084
MEDICARE PIN
SC
01
—
AA6763J577
MEDICARE PIN
SC
01
—
SCC9575019
MEDICARE PIN
SC
Enumeration date
07/14/2008
Last updated
12/21/2020
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