Individual provider · Type 1 NPI

Scott Lane Slate, PA-C

Surgical Physician Assistant · Winston Salem, NC

NPI number 1558595199 Active

Practice location

Medical Center Blvd
Winston Salem, NC 27157-0001

Call (336) 716-2255 Map

Fax (336) 716-8018

Mailing address

PO Box 344
Winston Salem, NC 27102-0344

Specialties and licenses

TaxonomyCodeLicense
Surgical Physician Assistant Primary 363AS0400X0010-01754 (NC)
Physician Assistant 363A00000X0010-01754 (NC)

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About NPI 1558595199

Scott Lane Slate, PA-C's National Provider Identifier is 1558595199, issued on May 12, 2009. The primary taxonomy on file is Surgical Physician Assistant (363AS0400X), and the practice location is in Winston Salem, NC. The record was last updated on Dec 19, 2011.