Provider Demographics
NPI:1396847554
Name:SILVIUS, RONALD D (DO)
Entity Type:Individual
Prefix:DR
First Name:RONALD
Middle Name:D
Last Name:SILVIUS
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 3755
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68103-0755
Mailing Address - Country:US
Mailing Address - Phone:402-354-2100
Mailing Address - Fax:402-354-2155
Practice Address - Street 1:320 EBAUGH ST
Practice Address - Street 2:
Practice Address - City:GLENWOOD
Practice Address - State:IA
Practice Address - Zip Code:51534-1811
Practice Address - Country:US
Practice Address - Phone:712-527-5204
Practice Address - Fax:712-527-9346
Is Sole Proprietor?:No
Enumeration Date:2006-09-01
Last Update Date:2013-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA3275207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA1396847554Medicaid
NE47068731712Medicaid
NE47068731712Medicaid
IA20199Medicare PIN