Provider Demographics
NPI:1376665141
Name:SILVERMAN, MITCHELL ROBERT (DC)
Entity Type:Individual
Prefix:DR
First Name:MITCHELL
Middle Name:ROBERT
Last Name:SILVERMAN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1703 E JOPPA RD
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21234-3638
Mailing Address - Country:US
Mailing Address - Phone:410-665-6666
Mailing Address - Fax:410-882-1264
Practice Address - Street 1:1703 E JOPPA RD
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21234-3638
Practice Address - Country:US
Practice Address - Phone:410-665-6666
Practice Address - Fax:410-882-1264
Is Sole Proprietor?:No
Enumeration Date:2007-04-04
Last Update Date:2007-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDSO1450111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NS0005XChiropractic ProvidersChiropractorSports Physician
Provider Identifiers
StateIdentifier IDID TypeIssuer
DCR420 0001OtherCAREFIRST OF DC
MDK687AGOtherCAREFIRST OF MD
MD680L329DMedicare PIN
MDK687AGOtherCAREFIRST OF MD