1831189083 NPI number — BARBARA D SLAGER M.D.

Table of content: BARBARA D SLAGER M.D. (NPI 1831189083)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1831189083 NPI number — BARBARA D SLAGER M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SLAGER
Provider First Name:
BARBARA
Provider Middle Name:
D
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1831189083
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
11/02/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
71 U.S. ROUTE ONE, SUITE A
Provider Second Line Business Mailing Address:
ELEVATION CENTER
Provider Business Mailing Address City Name:
SCARBOROUGH
Provider Business Mailing Address State Name:
ME
Provider Business Mailing Address Postal Code:
04074-9375
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
207-885-8400
Provider Business Mailing Address Fax Number:
207-885-8499

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
71 U.S. ROUTE ONE, SUITE A
Provider Second Line Business Practice Location Address:
ELEVATION CENTER
Provider Business Practice Location Address City Name:
SCARBOROUGH
Provider Business Practice Location Address State Name:
ME
Provider Business Practice Location Address Postal Code:
04074-9375
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
207-885-8400
Provider Business Practice Location Address Fax Number:
207-885-8499
Provider Enumeration Date:
10/27/2005

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207V00000X , with the licence number:  015951 , registered in the state of ME ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 329680099 , issued by the state of ( ME ) . This identifiers is of the category "MEDICAID".
  • Identifier: 8029351 . This is a "CIGNA" identifier , issued by the state of ( ME ) . This identifiers is of the category "OTHER".
  • Identifier: 043658 . This is a "ANTHEM" identifier , issued by the state of ( ME ) . This identifiers is of the category "OTHER".
  • Identifier: 2891105 . This is a "AETNA" identifier , issued by the state of ( ME ) . This identifiers is of the category "OTHER".
  • Identifier: 160057863 . This is a "GBA PALMETTO/RR MEDICARE" identifier , issued by the state of ( ME ) . This identifiers is of the category "OTHER".




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