MEDICARE: HANNAH ANN SLATE M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	01073056A	IN

General Provider Information

NPI Number	:	1518199272
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HANNAH ANN SLATE M.D.

Provider Business Mailing Address
First Line	:	3702 NEW VISION DR STE B
Second Line	:
City	:	FORT WAYNE
State	:	IN
Zip	:	46845-1703
Country	:	US
Telephone Number	:	260-266-8210
Fax Number	:

Provider Business Practice Location Address
First Line	:	8175 W US20
Second Line	:
City	:	SHIPSHEWANA
State	:	IN
Zip	:	46565-9169
Country	:	US
Telephone Number	:	260-768-7432
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/13/2009
Last Update Date	:	04/22/2026

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