Provider Demographics
NPI:1275616088
Name:SILVERBLATT, FREDRIC JOEL (MD)
Entity Type:Individual
Prefix:
First Name:FREDRIC
Middle Name:JOEL
Last Name:SILVERBLATT
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:PO BOX 229
Mailing Address - Street 2:
Mailing Address - City:WAKEFIELD
Mailing Address - State:RI
Mailing Address - Zip Code:02880-0229
Mailing Address - Country:US
Mailing Address - Phone:401-788-3337
Mailing Address - Fax:401-788-3939
Practice Address - Street 1:3461 S COUNTY TRL
Practice Address - Street 2:
Practice Address - City:EAST GREENWICH
Practice Address - State:RI
Practice Address - Zip Code:02818-1465
Practice Address - Country:US
Practice Address - Phone:401-471-6285
Practice Address - Fax:401-471-6284
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-23
Last Update Date:2015-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RI10640207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI409486OtherBLUE CHIP
RI7705393OtherAETNA TRADITIONAL CHOICE
RI9023437Medicaid
RI3528997OtherAETNA PPO
RI04-03935OtherUNITED HEALTH CARE
RI23437OtherBLUE CROSS
RI23437OtherBLUE CROSS
119023437Medicare ID - Type Unspecified