Provider Demographics
NPI:1386844702
Name:SLATE, GARRICK JAMES (MD)
Entity type:Individual
Prefix:DR
First Name:GARRICK
Middle Name:JAMES
Last Name:SLATE
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:43 WHITING HILL RD
Mailing Address - Street 2:SUITE 300
Mailing Address - City:BREWER
Mailing Address - State:ME
Mailing Address - Zip Code:04412-1005
Mailing Address - Country:US
Mailing Address - Phone:207-973-4670
Mailing Address - Fax:207-973-4669
Practice Address - Street 1:417 STATE ST
Practice Address - Street 2:SUITE 141
Practice Address - City:BANGOR
Practice Address - State:ME
Practice Address - Zip Code:04401-6630
Practice Address - Country:US
Practice Address - Phone:207-973-4670
Practice Address - Fax:207-973-4669
Is Sole Proprietor?:No
Enumeration Date:2007-07-24
Last Update Date:2021-07-28
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Provider Licenses
StateLicense IDTaxonomies
NJ25MA10909400207V00000X
VA0101243956207VX0000X
KY53114207V00000X
ME018106207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
No207VX0000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyObstetrics