Provider Demographics
NPI:1649777467
Name:SLATTERY, LAUREN (MD)
Entity type:Individual
Prefix:
First Name:LAUREN
Middle Name:
Last Name:SLATTERY
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:16 FAHY ST STE 202
Mailing Address - Street 2:
Mailing Address - City:BELFAST
Mailing Address - State:ME
Mailing Address - Zip Code:04915-6029
Mailing Address - Country:US
Mailing Address - Phone:207-505-4603
Mailing Address - Fax:207-560-9916
Practice Address - Street 1:16 FAHY ST STE 202
Practice Address - Street 2:
Practice Address - City:BELFAST
Practice Address - State:ME
Practice Address - Zip Code:04915-6029
Practice Address - Country:US
Practice Address - Phone:207-505-4603
Practice Address - Fax:207-560-9916
Is Sole Proprietor?:No
Enumeration Date:2018-04-09
Last Update Date:2025-05-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
UT11405490-1205208600000X
MEMD29359208600000X
NY331808208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery