Provider Demographics
NPI:1891964714
Name:SLATER, NANCY FISHER (MD)
Entity Type:Individual
Prefix:DR
First Name:NANCY
Middle Name:FISHER
Last Name:SLATER
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:8402 HARCOURT RD
Mailing Address - Street 2:STE 300
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46260-2074
Mailing Address - Country:US
Mailing Address - Phone:317-460-3572
Mailing Address - Fax:317-338-7154
Practice Address - Street 1:8402 HARCOURT RD
Practice Address - Street 2:STE 300
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46260-2074
Practice Address - Country:US
Practice Address - Phone:317-460-3572
Practice Address - Fax:317-338-7154
Is Sole Proprietor?:No
Enumeration Date:2008-02-25
Last Update Date:2012-04-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IN010281722080P0006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0006XAllopathic & Osteopathic PhysiciansPediatricsDevelopmental - Behavioral Pediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
A17482Medicare UPIN
147730Medicare PIN