Provider Demographics
NPI:1477544674
Name:SLOTNICK, LAWRENCE S (MD)
Entity Type:Individual
Prefix:DR
First Name:LAWRENCE
Middle Name:S
Last Name:SLOTNICK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:401 W DECATUR ST
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:NC
Mailing Address - Zip Code:27025-1913
Mailing Address - Country:US
Mailing Address - Phone:336-548-9618
Mailing Address - Fax:336-445-2227
Practice Address - Street 1:401 W DECATUR ST
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:NC
Practice Address - Zip Code:27025-1913
Practice Address - Country:US
Practice Address - Phone:336-548-9618
Practice Address - Fax:336-445-2227
Is Sole Proprietor?:No
Enumeration Date:2005-11-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC21720207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC77075OtherBCBS OF NC
NC3683OtherPARTNERS MEDICARE
NCC3857OtherMEDCOST
NC8977075Medicaid
NC4800239OtherUNITED HEALTHCARE
NCC3857OtherMEDCOST
NC4800239OtherUNITED HEALTHCARE
NCC86487Medicare UPIN