Provider Demographics
NPI:1811935042
Name:SLAUGHTER, WILLIAM (MD)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:
Last Name:SLAUGHTER
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 1:49 HANCOCK ST
Mailing Address - Street 2:
Mailing Address - City:CAMBRIDGE
Mailing Address - State:MA
Mailing Address - Zip Code:02139-3188
Mailing Address - Country:US
Mailing Address - Phone:617-233-8957
Mailing Address - Fax:
Practice Address - Street 1:49 HANCOCK ST
Practice Address - Street 2:
Practice Address - City:CAMBRIDGE
Practice Address - State:MA
Practice Address - Zip Code:02139-3188
Practice Address - Country:US
Practice Address - Phone:617-233-8957
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-02
Last Update Date:2010-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2200042084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA1086950OtherBEACON HEALTH
MA1811935042OtherUNITED BEHAVIORAL HEALTH
MA495436OtherTUFTS HEALTH PLAN
MA1811935042OtherPACIFICARE
MA33235OtherCIGNA
MAJ40610OtherBLUE CROSS
MA2128586Medicaid
MA33235OtherCIGNA
MAI66895Medicare UPIN