Provider Demographics
NPI:1659315570
Name:SILBER, GLENN MICHAEL (MD)
Entity Type:Individual
Prefix:
First Name:GLENN
Middle Name:MICHAEL
Last Name:SILBER
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:PO BOX 64264
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21264-4264
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:443-979-7944
Practice Address - Street 1:10025 GOVERNOR WARFIELD PKWY
Practice Address - Street 2:SUITE 410
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21044-3340
Practice Address - Country:US
Practice Address - Phone:410-730-6000
Practice Address - Fax:443-979-7944
Is Sole Proprietor?:No
Enumeration Date:2006-06-15
Last Update Date:2015-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDM24338207K00000X
MDD33273207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD395631800Medicaid
MD395631800Medicaid
MD176393ZBR2Medicare PIN