Provider Demographics
NPI:1821080748
Name:SLATER, TODD D (MD)
Entity Type:Individual
Prefix:
First Name:TODD
Middle Name:D
Last Name:SLATER
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:PO BOX 637736
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45263-7736
Mailing Address - Country:US
Mailing Address - Phone:513-891-1006
Mailing Address - Fax:513-793-1032
Practice Address - Street 1:1487 N HIGH ST
Practice Address - Street 2:SUITE 102
Practice Address - City:HILLSBORO
Practice Address - State:OH
Practice Address - Zip Code:45133-8496
Practice Address - Country:US
Practice Address - Phone:937-393-3406
Practice Address - Fax:937-393-0511
Is Sole Proprietor?:No
Enumeration Date:2005-08-17
Last Update Date:2012-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-050621207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0653561OtherAETNA
OH160054320OtherRAILROAD MEDICARE
OH000000198158OtherANTHEM
OH0720464OtherUHC
OH311674981OtherOTHER FACILITY TAX ID NUM
OH0590365Medicaid
OH2355062OtherRHC MEDICAID CLINIC NUM.
OH363843OtherRHC MEDICARE CLINIC NUM.
OH311674981OtherOTHER FACILITY TAX ID NUM
OH2355062OtherRHC MEDICAID CLINIC NUM.
OH0653561OtherAETNA