Provider Demographics
NPI:1134112931
Name:SILVERMAN, MICHAEL (MD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:
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 1:1112 PROSPECT AVE
Mailing Address - Street 2:
Mailing Address - City:MELROSE PARK
Mailing Address - State:PA
Mailing Address - Zip Code:19027-3060
Mailing Address - Country:US
Mailing Address - Phone:215-662-8356
Mailing Address - Fax:215-525-2777
Practice Address - Street 1:51 N 39TH ST
Practice Address - Street 2:M.O.B. SUITE 305
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19104-2640
Practice Address - Country:US
Practice Address - Phone:215-662-8356
Practice Address - Fax:215-525-2777
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-26
Last Update Date:2010-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD028927E207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0959722Medicaid
PA440002244OtherRAILROAD MEDICARE
PA440002244OtherRAILROAD MEDICARE
PA075155Medicare PIN