Provider Demographics
NPI:1447383328
Name:SILVERMAN, RONALD EMILE (PHD)
Entity Type:Individual
Prefix:
First Name:RONALD
Middle Name:EMILE
Last Name:SILVERMAN
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1213 BEARD STREET
Mailing Address - Street 2:
Mailing Address - City:FLINT
Mailing Address - State:MI
Mailing Address - Zip Code:48503-5372
Mailing Address - Country:US
Mailing Address - Phone:810-239-5220
Mailing Address - Fax:810-239-7267
Practice Address - Street 1:1213 BEARD STREET
Practice Address - Street 2:
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48503-5372
Practice Address - Country:US
Practice Address - Phone:810-239-5220
Practice Address - Fax:810-239-7267
Is Sole Proprietor?:No
Enumeration Date:2007-03-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6301001364103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIP2771001Medicare ID - Type Unspecified