Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207V00000X | Obstetrician & Gynecologist | 018106 | ME |
N | 207V00000X | Obstetrician & Gynecologist | 25MA10909400 | NJ |
N | 207V00000X | Obstetrician & Gynecologist | 53114 | KY |
N | 207VX0000X | Obstetrician | 0101243956 | VA |
NPI | 1386844702 |
---|---|
Provider Name | Dr. Garrick James Slate |
First Address | Brewer, ME 04412-1005 |
Second Address | Bangor, ME 04401-6630 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/07/2007 |
Last Update Date | 28/07/2021 |