Provider Demographics
NPI:1295846400
Name:SILODOR, STEVEN ANDREW (DO)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:ANDREW
Last Name:SILODOR
Suffix:
Gender:M
Credentials:DO
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Mailing Address - Street 1:4215 N DRINKWATER BLVD
Mailing Address - Street 2:APT 338
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85251-3930
Mailing Address - Country:US
Mailing Address - Phone:480-878-4229
Mailing Address - Fax:480-878-4229
Practice Address - Street 1:1201 S 7TH AVE
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85007-3917
Practice Address - Country:US
Practice Address - Phone:602-344-6655
Practice Address - Fax:602-344-6655
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2015-01-15
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NJMB67987207Q00000X
NY223867-1207Q00000X
AZ4785207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ035083Medicare PIN
NJH09797Medicare UPIN