Provider Demographics
NPI:1538103478
Name:SILVIA, KRISTEN B (MD)
Entity Type:Individual
Prefix:
First Name:KRISTEN
Middle Name:B
Last Name:SILVIA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:301C US ROUTE 1
Mailing Address - Street 2:
Mailing Address - City:SCARBOROUGH
Mailing Address - State:ME
Mailing Address - Zip Code:04074-9701
Mailing Address - Country:US
Mailing Address - Phone:207-396-8600
Mailing Address - Fax:207-396-8632
Practice Address - Street 1:96 CAMPUS DR
Practice Address - Street 2:SUITE 2C
Practice Address - City:SCARBOROUGH
Practice Address - State:ME
Practice Address - Zip Code:04074-7163
Practice Address - Country:US
Practice Address - Phone:207-883-7926
Practice Address - Fax:207-883-1925
Is Sole Proprietor?:No
Enumeration Date:2006-06-15
Last Update Date:2021-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEMD17120207Q00000X, 207QA0401X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QA0401XAllopathic & Osteopathic PhysiciansFamily MedicineAddiction Medicine
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH30208129Medicaid
ME293280099Medicaid
NH30208129Medicaid
MEP00928349Medicare PIN
MEP00365983Medicare PIN
ME293280099Medicaid
MEE400118328Medicare PIN
ME080127980Medicare PIN
MESX4734Medicare PIN
MEME2253Medicare PIN