Provider Demographics
NPI:1033103775
Name:SILVERSTEIN, LOUIS NMI (MD)
Entity Type:Individual
Prefix:
First Name:LOUIS
Middle Name:NMI
Last Name:SILVERSTEIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:805 S UNION AVE
Mailing Address - Street 2:
Mailing Address - City:HAVRE DE GRACE
Mailing Address - State:MD
Mailing Address - Zip Code:21078-3610
Mailing Address - Country:US
Mailing Address - Phone:410-939-5843
Mailing Address - Fax:410-939-3538
Practice Address - Street 1:805 S UNION AVE
Practice Address - Street 2:
Practice Address - City:HAVRE DE GRACE
Practice Address - State:MD
Practice Address - Zip Code:21078-3610
Practice Address - Country:US
Practice Address - Phone:410-939-5843
Practice Address - Fax:410-939-3538
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-08
Last Update Date:2008-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD27154208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD030701700Medicaid
MD439112OtherBLUE CROSS BLUE SHIELD
MD110029325Medicare PIN
MD439112OtherBLUE CROSS BLUE SHIELD
MDD73725Medicare UPIN