Provider Demographics
NPI:1487646543
Name:SILVER, RICHARD STANLEY (DO)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:STANLEY
Last Name:SILVER
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:11890 KINSMAN RD
Mailing Address - Street 2:PO BOX 382
Mailing Address - City:NEWBURY
Mailing Address - State:OH
Mailing Address - Zip Code:44065-0382
Mailing Address - Country:US
Mailing Address - Phone:440-832-7009
Mailing Address - Fax:440-273-3143
Practice Address - Street 1:11890 KINSMAN RD
Practice Address - Street 2:
Practice Address - City:NEWBURY
Practice Address - State:OH
Practice Address - Zip Code:44065-9690
Practice Address - Country:US
Practice Address - Phone:440-832-7009
Practice Address - Fax:440-273-3143
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-16
Last Update Date:2009-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH34-00-2391-S207QA0401X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QA0401XAllopathic & Osteopathic PhysiciansFamily MedicineAddiction Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0282402Medicaid
OH10830886OtherCAQH
OH10830886OtherCAQH
OH0417281Medicare PIN