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Individual

MR. JAMES JONATHAN SLATER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.O.

Contact information

Practice address
2611 CHARLEVOIX AVE, PETOSKEY, MI 49770-8524
(231) 348-5900
(231) 348-5901
Mailing address
2611 CHARLEVOIX AVE, PETOSKEY, MI 49770-8524
(231) 348-5900
(231) 348-5901

Taxonomy

Speciality
Code
Description
License number
State
207YX0905X
Otolaryngology/Facial Plastic Surgery Physician
Primary
5101015870
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0451601125
BCBS
MI
01
1356394803
NPI, NORTHWOODS ENT
MI
05
4832946-11
MI
Enumeration date
09/28/2007
Last updated
05/11/2012
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