Provider Demographics
NPI:1174020705
Name:SLATER, MICHAEL WILLIAM JR (DO)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:WILLIAM
Last Name:SLATER
Suffix:JR
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:34 CLAFFORD LN
Mailing Address - Street 2:
Mailing Address - City:MELVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:11747-1310
Mailing Address - Country:US
Mailing Address - Phone:631-470-3401
Mailing Address - Fax:
Practice Address - Street 1:851 5TH AVE N STE 306
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34102-5582
Practice Address - Country:US
Practice Address - Phone:239-624-0030
Practice Address - Fax:239-624-0031
Is Sole Proprietor?:No
Enumeration Date:2018-04-10
Last Update Date:2021-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program