Provider Demographics
NPI:1326209867
Name:SILVEY, JENNIFER R (MD)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:R
Last Name:SILVEY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2875 W MARKET ST
Mailing Address - Street 2:
Mailing Address - City:FAIRLAWN
Mailing Address - State:OH
Mailing Address - Zip Code:44333-4064
Mailing Address - Country:US
Mailing Address - Phone:330-865-6530
Mailing Address - Fax:234-312-2305
Practice Address - Street 1:2875 W MARKET ST
Practice Address - Street 2:
Practice Address - City:FAIRLAWN
Practice Address - State:OH
Practice Address - Zip Code:44333-4064
Practice Address - Country:US
Practice Address - Phone:330-865-6530
Practice Address - Fax:234-317-2305
Is Sole Proprietor?:No
Enumeration Date:2008-06-18
Last Update Date:2019-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35092989207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2923779Medicaid
OH2923779Medicaid