Provider Demographics
NPI:1043378292
Name:SILVERMAN, MITCHELL S (MD)
Entity Type:Individual
Prefix:DR
First Name:MITCHELL
Middle Name:S
Last Name:SILVERMAN
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 1:2333 MORRIS AVE
Mailing Address - Street 2:B-9
Mailing Address - City:UNION
Mailing Address - State:NJ
Mailing Address - Zip Code:07083-5714
Mailing Address - Country:US
Mailing Address - Phone:908-964-5511
Mailing Address - Fax:908-964-5718
Practice Address - Street 1:2333 MORRIS AVE
Practice Address - Street 2:B-9
Practice Address - City:UNION
Practice Address - State:NJ
Practice Address - Zip Code:07083-5714
Practice Address - Country:US
Practice Address - Phone:908-964-5511
Practice Address - Fax:908-964-5718
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-04
Last Update Date:2008-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA05161300207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ1042700Medicaid
NJ1042700Medicaid
NJE13179Medicare UPIN