Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213E00000X | Podiatrist | 1778 | MA |
Y | 222Z00000X | Podiatrist | 1778 | MA |
NPI | 1033204268 |
---|---|
Provider Name | Mitchell G Silverman |
First Address | Cumberland, RI 02864-1208 |
Second Address | Dorchester, MA 02125-2424 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 04/10/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0361488 | (05) | MA |
T58768 | (02) | MA |