Provider Demographics
NPI:1043780653
Name:SILVERMAN, DOUGLAS BENNETT (PSYD)
Entity Type:Individual
Prefix:DR
First Name:DOUGLAS
Middle Name:BENNETT
Last Name:SILVERMAN
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 BLUE MOON XING # 252
Mailing Address - Street 2:
Mailing Address - City:POOLER
Mailing Address - State:GA
Mailing Address - Zip Code:31322-9797
Mailing Address - Country:US
Mailing Address - Phone:912-450-0594
Mailing Address - Fax:
Practice Address - Street 1:400 MAIN ST STE 200A-6
Practice Address - Street 2:
Practice Address - City:HILTON HEAD
Practice Address - State:SC
Practice Address - Zip Code:29926-4610
Practice Address - Country:US
Practice Address - Phone:912-417-9541
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-11-27
Last Update Date:2019-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPSY004255103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical