Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XX0004X | Foot and Ankle Orthopaedic Surgeon | 46411 | MN |
NPI | 1609872159 |
---|---|
Provider Name | Lance Michael Silverman |
First Address | Edina, MN 55435-1807 |
Second Address | Edina, MN 55435-1807 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 21/06/2005 |
Last Update Date | 10/11/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
200002310 | MEDICARE PROVIDER NUMBER (01) | |
974832300 | (05) | MN |
H35859 | (02) |