Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Q00000X | Family Doctor | MD17120 | ME |
Y | 207QA0401X | Family Doctor - Addiction Medicine | MD17120 | ME |
NPI | 1538103478 |
---|---|
Provider Name | Kristen B. Silvia |
First Address | Scarborough, ME 04074-9701 |
Second Address | Scarborough, ME 04074-7163 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/06/2006 |
Last Update Date | 31/08/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
293280099 | (05) | ME |
30208129 | (05) | NH |
G26282 | (02) | ME |