Provider Demographics
NPI:1750354957
Name:SCHIFF-SLATER, SCOTT DAVID (MD)
Entity type:Individual
Prefix:MR
First Name:SCOTT
Middle Name:DAVID
Last Name:SCHIFF-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 1:9 UNION ST
Mailing Address - Street 2:
Mailing Address - City:HALLOWELL
Mailing Address - State:ME
Mailing Address - Zip Code:04347
Mailing Address - Country:US
Mailing Address - Phone:207-626-0606
Mailing Address - Fax:207-626-0022
Practice Address - Street 1:9 UNION ST
Practice Address - Street 2:
Practice Address - City:HALLOWELL
Practice Address - State:ME
Practice Address - Zip Code:04347
Practice Address - Country:US
Practice Address - Phone:207-626-0606
Practice Address - Fax:207-626-0022
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-08
Last Update Date:2020-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME013527207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
F53854OtherHARVARD
2358881OtherAETNA
5281052002OtherCIGNA
ME299990099Medicaid
040818OtherANTHEM
80167597OtherRAILROAD MEDICARE
5281052002OtherMED UNITED
80167597OtherTRAVELERS MEDICARE
F53854Medicare UPIN
F53854OtherHARVARD