Provider Demographics
NPI:1497868921
Name:SILOW, CHARLES (PHD)
Entity Type:Individual
Prefix:DR
First Name:CHARLES
Middle Name:
Last Name:SILOW
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 1:5143 CASS ELIZABETH RD
Mailing Address - Street 2:
Mailing Address - City:WATERFORD
Mailing Address - State:MI
Mailing Address - Zip Code:48327-3224
Mailing Address - Country:US
Mailing Address - Phone:248-542-1215
Mailing Address - Fax:248-542-1215
Practice Address - Street 1:5143 CASS ELIZABETH RD
Practice Address - Street 2:
Practice Address - City:WATERFORD
Practice Address - State:MI
Practice Address - Zip Code:48327-3224
Practice Address - Country:US
Practice Address - Phone:248-542-1215
Practice Address - Fax:248-542-1215
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-17
Last Update Date:2011-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MICS008905103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI680F330220OtherBCBS
MIR65650Medicare UPIN
MI0M19660Medicare ID - Type Unspecified