Provider Demographics
NPI:1588657183
Name:SILKA, MICHAEL (CRNA)
Entity Type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:
Last Name:SILKA
Suffix:
Gender:M
Credentials:CRNA
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 1547
Mailing Address - Street 2:
Mailing Address - City:MANSFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:44901-1547
Mailing Address - Country:US
Mailing Address - Phone:567-274-0014
Mailing Address - Fax:
Practice Address - Street 1:3300 WELTY RD
Practice Address - Street 2:
Practice Address - City:LUCAS
Practice Address - State:OH
Practice Address - Zip Code:44843-9729
Practice Address - Country:US
Practice Address - Phone:419-892-5798
Practice Address - Fax:419-892-2694
Is Sole Proprietor?:No
Enumeration Date:2005-08-30
Last Update Date:2011-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN320687367500000X
OHNA08429367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered