Provider Demographics
NPI:1174020705
Name:SLATER, MICHAEL WILLIAM JR (DO)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:WILLIAM
Last Name:SLATER
Suffix:JR
Gender:M
Credentials:DO
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Mailing Address - Street 1:PO BOX 947407
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30394-7407
Mailing Address - Country:US
Mailing Address - Phone:941-917-2600
Mailing Address - Fax:941-917-7884
Practice Address - Street 1:200 HEALTHCARE WAY STE 202
Practice Address - Street 2:
Practice Address - City:NORTH VENICE
Practice Address - State:FL
Practice Address - Zip Code:34275-3669
Practice Address - Country:US
Practice Address - Phone:941-262-0400
Practice Address - Fax:941-262-0410
Is Sole Proprietor?:No
Enumeration Date:2018-04-10
Last Update Date:2024-09-10
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Provider Licenses
StateLicense IDTaxonomies
FLOS21412207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology