Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 111N00000X | Chiropractor | DC006586L | PA |
Y | 111NS0005X | Chiropractic Sports Physician | DC006586L | PA |
NPI | 1366489981 |
---|---|
Provider Name | Dr. Scott J Silverman |
First Address | Philadelphia, PA 19135-2313 |
Second Address | Philadelphia, PA 19135-2313 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/06/2006 |
Last Update Date | 21/09/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
SI883436 | (02) | PA |