Provider Demographics
NPI:1912165754
Name:SLAWSKY, NATHAN PETER (DC)
Entity Type:Individual
Prefix:DR
First Name:NATHAN
Middle Name:PETER
Last Name:SLAWSKY
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:651 ORCHARD ST
Mailing Address - Street 2:STE 202A
Mailing Address - City:NEW BEDFORD
Mailing Address - State:MA
Mailing Address - Zip Code:02744-1008
Mailing Address - Country:US
Mailing Address - Phone:508-717-0222
Mailing Address - Fax:508-714-0299
Practice Address - Street 1:651 ORCHARD ST
Practice Address - Street 2:STE 202A
Practice Address - City:NEW BEDFORD
Practice Address - State:MA
Practice Address - Zip Code:02744-1008
Practice Address - Country:US
Practice Address - Phone:508-717-0222
Practice Address - Fax:508-714-0299
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-29
Last Update Date:2013-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2779111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MASLY36924OtherBLUE CROSS AND BLUE SHIELD
MA1600991Medicaid
MA1600991Medicaid