Provider Demographics
NPI:1528223310
Name:SLAUGHTER-ATIEMO, CHARLRE' EVANTHONI (MD)
Entity Type:Individual
Prefix:DR
First Name:CHARLRE'
Middle Name:EVANTHONI
Last Name:SLAUGHTER-ATIEMO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4255 ALTAMONT PLACE
Mailing Address - Street 2:SUITE 301
Mailing Address - City:WHITE PLAINS
Mailing Address - State:MD
Mailing Address - Zip Code:20695
Mailing Address - Country:US
Mailing Address - Phone:301-645-1781
Mailing Address - Fax:301-374-9237
Practice Address - Street 1:4255 ALTAMONT PLACE
Practice Address - Street 2:SUITE 301
Practice Address - City:WHITE PLAINS
Practice Address - State:MD
Practice Address - Zip Code:20695
Practice Address - Country:US
Practice Address - Phone:215-726-9807
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-07-22
Last Update Date:2015-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMT193618208000000X
MDD0076072208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics