Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208D00000X | General Practice Physician | D27154 | MD |
NPI | 1033103775 |
---|---|
Provider Name | Louis Nmi Silverstein |
First Address | Havre De Grace, MD 21078-3610 |
Second Address | Havre De Grace, MD 21078-3610 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/09/2005 |
Last Update Date | 09/06/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
030701700 | (05) | MD |
439112 | BLUE CROSS BLUE SHIELD (01) | MD |
D73725 | (02) | MD |