Provider Demographics
NPI:1437177870
Name:SILVER, DAVID MICAH
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:MICAH
Last Name:SILVER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28 SOUTH MAIN ST
Mailing Address - Street 2:
Mailing Address - City:CHESHIRE
Mailing Address - State:CT
Mailing Address - Zip Code:06410
Mailing Address - Country:US
Mailing Address - Phone:203-271-3296
Mailing Address - Fax:203-439-0261
Practice Address - Street 1:28 SOUTH MAIN ST
Practice Address - Street 2:
Practice Address - City:CHESHIRE
Practice Address - State:CT
Practice Address - Zip Code:06410
Practice Address - Country:US
Practice Address - Phone:203-272-3364
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000478207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT040000478CT04OtherANTHEM BCBS
CT040000478CT03OtherANTHEM BCBS
2V5736OtherHEALTHNET
1216857OtherAETNA HEALTH PLANS
P840692OtherOXFORD
000478OtherCONNECTICARE
G64649Medicare UPIN
110009859Medicare ID - Type Unspecified