Provider Demographics
NPI:1508320367
Name:TODD B. SILVERMAN MD, LLC
Entity Type:Organization
Organization Name:TODD B. SILVERMAN MD, LLC
Other - Org Name:TODD B. SILVERMAN MD
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:TODD
Authorized Official - Middle Name:
Authorized Official - Last Name:SILVERMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:636-537-0525
Mailing Address - Street 1:14825 NORTH OUTER 40 RD STE 330-B
Mailing Address - Street 2:
Mailing Address - City:CHESTERFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:63017-2119
Mailing Address - Country:US
Mailing Address - Phone:636-537-0525
Mailing Address - Fax:636-537-0575
Practice Address - Street 1:14825 NORTH OUTER 40 RD STE 330-B
Practice Address - Street 2:
Practice Address - City:CHESTERFIELD
Practice Address - State:MO
Practice Address - Zip Code:63017-2119
Practice Address - Country:US
Practice Address - Phone:636-537-0525
Practice Address - Fax:636-537-0575
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-25
Last Update Date:2019-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Multi-Specialty
No2084N0600XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyClinical NeurophysiologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO1114016391OtherINDIVIDUAL NPI