Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207N00000X | Dermatologist | 2020-00395 | NC |
N | 207ND0900X | Dermatopathologist | 2020-00395 | NC |
NPI | 1548647613 |
---|---|
Provider Name | Dr. Nathaniel Allen Slater |
First Address | Concord, NC 28025-1221 |
Second Address | Concord, NC 28025-1221 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/04/2015 |
Last Update Date | 04/08/2020 |