Provider Demographics
NPI:1447235486
Name:SLATER, DENNIS (MD)
Entity Type:Individual
Prefix:
First Name:DENNIS
Middle Name:
Last Name:SLATER
Suffix:
Gender:M
Credentials:MD
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Other - Last Name:
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Mailing Address - Street 1:330 WASHINGTON ST
Mailing Address - Street 2:EASTERN CT HEMATOLOGY & ONCOLOGY SUITE 220
Mailing Address - City:NORWICH
Mailing Address - State:CT
Mailing Address - Zip Code:06360-2700
Mailing Address - Country:US
Mailing Address - Phone:860-886-8362
Mailing Address - Fax:860-886-9262
Practice Address - Street 1:330 WASHINGTON ST
Practice Address - Street 2:EASTERN CT HEMATOLOGY & ONCOLOGY SUITE 220
Practice Address - City:NORWICH
Practice Address - State:CT
Practice Address - Zip Code:06360-2700
Practice Address - Country:US
Practice Address - Phone:860-886-8362
Practice Address - Fax:860-886-9262
Is Sole Proprietor?:No
Enumeration Date:2005-12-13
Last Update Date:2013-07-22
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Provider Licenses
StateLicense IDTaxonomies
CT026872207RH0000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0000XAllopathic & Osteopathic PhysiciansInternal MedicineHematology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT001268721Medicaid
CT0113957OtherAETNA
CT010026872CT02OtherBCBS
C65093Medicare UPIN
CT001268721Medicaid