Provider Demographics
NPI:1467526897
Name:SILBERBERG, PHILLIP J (MD)
Entity Type:Individual
Prefix:
First Name:PHILLIP
Middle Name:J
Last Name:SILBERBERG
Suffix:
Gender:M
Credentials:MD
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 9007
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22906-9007
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:800 ROSE ST
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40536-7105
Practice Address - Country:US
Practice Address - Phone:859-323-2406
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-18
Last Update Date:2019-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY482022085P0229X
VA01012641222085P0229X
IN01070185A2085R0202X
OH350996602085R0202X
KY418022085P0229X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085P0229XAllopathic & Osteopathic PhysiciansRadiologyPediatric Radiology
No2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY000000562240OtherANTHEM KCR
IN200916310Medicaid
KY3508257000OtherPASSPORT ADVTG-KCR
KY50018781OtherPASSPORT-KCR
KY00533038OtherKY MEDICARE KCR
NE241171OtherMIDLANDS CHOICE
NE35325OtherBCBS
KY000023033JOtherHUMANA - KCR
KS200004310AMedicaid
KY7100034780Medicaid
IA572107Medicaid
KS200004310AMedicaid