Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207V00000X | Obstetrician & Gynecologist | 12158 | PR |
N | 207VX0000X | Obstetrician | 12158 | PR |
NPI | 1245225523 |
---|---|
Provider Name | Dr. Samuel D. Silva |
First Address | San Juan, PR 00917-3632 |
Second Address | San Juan, PR 00917 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 13/09/2005 |
Last Update Date | 07/09/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
G-41009 | (02) | PR |