Provider Demographics
NPI:1720019938
Name:SILVERMAN, RICHARD T (MD)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:T
Last Name:SILVERMAN
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 1:29 CRAFTS ST
Mailing Address - Street 2:SUITE 370
Mailing Address - City:NEWTON
Mailing Address - State:MA
Mailing Address - Zip Code:02458-1275
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:29 CRAFTS ST
Practice Address - Street 2:SUITE 370
Practice Address - City:NEWTON
Practice Address - State:MA
Practice Address - Zip Code:02458-1275
Practice Address - Country:US
Practice Address - Phone:617-965-9500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-05
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA76050208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA6361978004OtherCIGNA
MA4485114OtherAETNA
MAJ12717OtherBCBS
MA076050OtherTUFTS
MA3063968Medicaid
MA3063968Medicaid