Thomas K Slack, M.D.
Individual provider Active NPI Nephrology Physician · Wellfleet, MA
NPI 1023040565 · NPPES record last updated Nov 24, 2009
Key facts
- NPI
- 1023040565
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Nephrology Physician 207RN0300X
- License
- 212331 (MA)
- Practice address
- 126 Eastwind Cir
Wellfleet, MA 02667-8504 - Phone
- (508) 349-0948
- NPI assigned
- Jul 7, 2006
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 212331 | MA | MD | Nephrology Physician |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nephrology Physician | 207RN0300X | 212331 | MA | Yes |
Addresses
Primary practice location
126 Eastwind Cir
Wellfleet, MA 02667-8504
Mailing address
126 Eastwind Cir
Wellfleet, MA 02667-8504
Phone (508) 349-0948
Other providers in Wellfleet, MA
- John Nathan Ross
- Jacqueline Beaupre Rozza
- Dianne M Schermerhorn
- Daniella Julia Schutzengel
- Sea Smiles Dental Hygiene
- Brianne Smith
- Susan E Smith
- Susan Spaniol
- H Todd Spencer
- Jennifer Hope Subrin
All providers in Wellfleet, MA · Nephrology Physician in Massachusetts
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 24, 2009. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.