Provider Demographics
NPI:1417579855
Name:SLATER, MICHAEL BRIAN (AU D)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:BRIAN
Last Name:SLATER
Suffix:
Gender:M
Credentials:AU D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9710 SAM FURR RD UNIT D
Mailing Address - Street 2:
Mailing Address - City:HUNTERSVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28078-4928
Mailing Address - Country:US
Mailing Address - Phone:704-896-1909
Mailing Address - Fax:
Practice Address - Street 1:9710 SAM FURR RD UNIT D
Practice Address - Street 2:
Practice Address - City:HUNTERSVILLE
Practice Address - State:NC
Practice Address - Zip Code:28078-4928
Practice Address - Country:US
Practice Address - Phone:704-896-1909
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-05-08
Last Update Date:2020-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC14396OtherNORTH CAROLINA BOARD OF EXAMINERS IN SPEECH & LANGUAGE PATHOLOGY & AUDIOLOGY