Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 026872 | CT |
N | 111NI0900X | Internist | 026872 | CT |
Y | 207RH0000X | Hematologist | 026872 | CT |
NPI | 1447235486 |
---|---|
Provider Name | Dennis Slater |
First Address | Norwich, CT 06360-2700 |
Second Address | Norwich, CT 06360-2700 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/12/2005 |
Last Update Date | 22/07/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
001268721 | (05) | CT |
010026872CT02 | BCBS (01) | CT |
0113957 | AETNA (01) | CT |
C65093 | (02) |