Provider Demographics
NPI:1326247321
Name:SILVA, ROSANNA DELVERME (DO)
Entity Type:Individual
Prefix:
First Name:ROSANNA
Middle Name:DELVERME
Last Name:SILVA
Suffix:
Gender:F
Credentials:DO
Other - Prefix:DR
Other - First Name:ROSANNA
Other - Middle Name:
Other - Last Name:DEL VERME SILVA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DO
Mailing Address - Street 1:PO BOX 60447
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28260-0447
Mailing Address - Country:US
Mailing Address - Phone:704-384-7840
Mailing Address - Fax:704-384-7830
Practice Address - Street 1:4500 CAMERON VALLEY PKWY STE 100
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28211-3542
Practice Address - Country:US
Practice Address - Phone:704-384-7910
Practice Address - Fax:704-384-7914
Is Sole Proprietor?:No
Enumeration Date:2007-07-11
Last Update Date:2020-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2012-00192207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC5920390Medicaid
NCNC6444AMedicare PIN