Provider Demographics
NPI:1356485189
Name:SUMET SILAPASWAN M D PC
Entity Type:Organization
Organization Name:SUMET SILAPASWAN M D PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SUMET
Authorized Official - Middle Name:
Authorized Official - Last Name:SILAPASWAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:248-559-5115
Mailing Address - Street 1:26850 PROVIDENCE PKWY
Mailing Address - Street 2:STE 504
Mailing Address - City:NOVI
Mailing Address - State:MI
Mailing Address - Zip Code:48374-1213
Mailing Address - Country:US
Mailing Address - Phone:248-559-5115
Mailing Address - Fax:248-662-3022
Practice Address - Street 1:26850 PROVIDENCE PKWY
Practice Address - Street 2:STE 504
Practice Address - City:NOVI
Practice Address - State:MI
Practice Address - Zip Code:48374-1213
Practice Address - Country:US
Practice Address - Phone:248-559-5115
Practice Address - Fax:248-662-3022
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-16
Last Update Date:2010-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MISS033649208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIA76666OtherHAP
MI105432OtherGREAT LAKES
MI316751OtherPRORITY HEALTH
MI020F369850OtherBCN GROUP
MIDQ2043OtherRAILROAD MEDICARE
MI016655OtherMIDWEST HEALTH PLAN
MI020F369850OtherBCBS GROUP
MI133835901OtherUNITED HEALTH PLAN
MI7120511OtherAETNA
MI1356485189Medicaid
MI016655OtherMIDWEST HEALTH PLAN
MI105432OtherGREAT LAKES