Provider Demographics
NPI:1154478865
Name:SYLVESTER, SALVADOR (MD)
Entity Type:Individual
Prefix:
First Name:SALVADOR
Middle Name:
Last Name:SYLVESTER
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 1:2754 HAMBLETON RD
Mailing Address - Street 2:
Mailing Address - City:RIVA
Mailing Address - State:MD
Mailing Address - Zip Code:21140-1135
Mailing Address - Country:US
Mailing Address - Phone:301-785-6206
Mailing Address - Fax:240-777-5132
Practice Address - Street 1:6201 GREENBELT RD STE M16
Practice Address - Street 2:
Practice Address - City:BERWYN HEIGHTS
Practice Address - State:MD
Practice Address - Zip Code:20740-2333
Practice Address - Country:US
Practice Address - Phone:301-441-4400
Practice Address - Fax:301-441-3008
Is Sole Proprietor?:No
Enumeration Date:2007-01-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDH0055927207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD008460M45Medicare ID - Type Unspecified
MDH28849Medicare UPIN