Organization
BLAKE M SLATER D O P C
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BLAKE M SLATER (D O)
(906) 484-2295
Entity
Organization
Contact information
Practice address
391 EAST HIGHWAY M-134, POB 630, CEDARVILLE, MI 49719-0630
(906) 484-2295
(906) 484-2614
Mailing address
PO BOX 630, CEDARVILLE, MI 49719-0630
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
007998
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1779863
—
MI
Enumeration date
12/28/2007
Last updated
11/23/2009
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