Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2081P2900X | Pain Medicine | 20780 | AZ |
NPI | 1346417060 |
---|---|
Provider Name | Laurance Silverman |
First Address | Tucson, AZ 85715-4005 |
Second Address | Tucson, AZ 85715-4005 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/05/2008 |
Last Update Date | 12/05/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
E10684 | (02) | AZ |