Provider Demographics
NPI:1609968957
Name:SILVERNAGEL, SEAN W (MD)
Entity Type:Individual
Prefix:DR
First Name:SEAN
Middle Name:W
Last Name:SILVERNAGEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5301 VIRGINIA WAY
Mailing Address - Street 2:STE 300
Mailing Address - City:BRENTWOOD
Mailing Address - State:TN
Mailing Address - Zip Code:37027-7541
Mailing Address - Country:US
Mailing Address - Phone:615-695-4977
Mailing Address - Fax:615-263-3348
Practice Address - Street 1:5301 VIRGINIA WAY
Practice Address - Street 2:STE 300
Practice Address - City:BRENTWOOD
Practice Address - State:TN
Practice Address - Zip Code:37027-7541
Practice Address - Country:US
Practice Address - Phone:615-695-4977
Practice Address - Fax:615-263-3348
Is Sole Proprietor?:No
Enumeration Date:2006-09-28
Last Update Date:2015-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN34225207ZP0102X
KY35633207ZP0102X
IN01046239207ZP0102X
IL036102655207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL009964110Medicaid
TN3852374Medicaid
TN100031755OtherPHP TENNCARE
TN119430OtherUNISON TENNCARE
KY64029960Medicaid
TN000000016446OtherTLC TENNCARE
TN3149862OtherBLUE CROSS
G95257Medicare UPIN
AL009964110Medicaid