Provider Demographics
NPI:1902311640
Name:SLATER, EVAN JOHN (PHARMD)
Entity Type:Individual
Prefix:
First Name:EVAN
Middle Name:JOHN
Last Name:SLATER
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4700 HALE PKWY STE 400
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80220-4051
Mailing Address - Country:US
Mailing Address - Phone:303-285-5085
Mailing Address - Fax:303-930-5517
Practice Address - Street 1:4700 HALE PKWY STE 400
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80220-4051
Practice Address - Country:US
Practice Address - Phone:303-285-5085
Practice Address - Fax:303-930-5517
Is Sole Proprietor?:No
Enumeration Date:2017-12-04
Last Update Date:2017-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO166831835X0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835X0200XPharmacy Service ProvidersPharmacistOncology