Provider Demographics
NPI:1457308454
Name:SLATER, A DAVID (MD)
Entity Type:Individual
Prefix:DR
First Name:A
Middle Name:DAVID
Last Name:SLATER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:201 ABRAHAM FLEXNER WAY
Mailing Address - Street 2:SUITE 1200
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40202-3841
Mailing Address - Country:US
Mailing Address - Phone:502-561-2180
Mailing Address - Fax:502-561-2190
Practice Address - Street 1:201 ABRAHAM FLEXNER WAY
Practice Address - Street 2:SUITE 1200
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40202-3841
Practice Address - Country:US
Practice Address - Phone:502-561-2180
Practice Address - Fax:502-561-2190
Is Sole Proprietor?:No
Enumeration Date:2006-05-27
Last Update Date:2008-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY24173208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY330002430OtherMEDICARE RR
KY64241730Medicaid
IN100347660Medicaid
KY330002430OtherMEDICARE RR
IN100347660Medicaid