Healthcare Provider Details

I. General information

NPI: 1508270737
Provider Name (Legal Business Name): JASON MUNRO SLATER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/16/2014
Last Update Date: 09/18/2026
Certification Date: 09/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2014 WASHINGTON ST
NEWTON MA
02462-1607
US

IV. Provider business mailing address

55 FRUIT ST LUNDER LL235
BOSTON MA
02114-2696
US

V. Phone/Fax

Practice location:
  • Phone: 617-219-1200
  • Fax:
Mailing address:
  • Phone: 617-724-9413
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2085R0001X
TaxonomyRadiation Oncology Physician
License NumberETL587
License Number StateMA
# 2
Primary TaxonomyY
Taxonomy Code2085R0001X
TaxonomyRadiation Oncology Physician
License NumberA143146
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: