Healthcare Provider Details

I. General information

NPI: 1568029676
Provider Name (Legal Business Name): ANDREW M SLATER DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/23/2019
Last Update Date: 06/29/2026
Certification Date: 06/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 ABBEYVILLE ROAD
LANCASTER PA
17603-4603
US

IV. Provider business mailing address

101 ABBEYVILLE ROAD
LANCASTER PA
17603-4603
US

V. Phone/Fax

Practice location:
  • Phone: 717-291-5991
  • Fax: 717-291-5806
Mailing address:
  • Phone: 717-291-5991
  • Fax: 717-291-5806

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberOS021819
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: