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Individual

DR. JONATHAN SLATER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
100 WASON AVE, SUITE 200, SPRINGFIELD, MA 01107-1381
(413) 733-9666
(413) 750-3432
Mailing address
PO BOX 70266, SPRINGFIELD, MA 01107-0266
(413) 733-9666
(413) 750-3432

Taxonomy

Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
032013
CT
207RN0300X
Nephrology Physician
Primary
81014
MA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
10252
HARVARD PILGRIM
MA
05
3137651
MA
01
64747
FALLON
MA
Enumeration date
11/22/2005
Last updated
02/06/2015
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