Provider Demographics
NPI:1780824714
Name:SILVER, SARA A (DO)
Entity Type:Individual
Prefix:DR
First Name:SARA
Middle Name:A
Last Name:SILVER
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:452 W BANKHEAD ST
Mailing Address - Street 2:
Mailing Address - City:NEW ALBANY
Mailing Address - State:MS
Mailing Address - Zip Code:38652-3319
Mailing Address - Country:US
Mailing Address - Phone:662-432-0961
Mailing Address - Fax:662-432-0965
Practice Address - Street 1:452 W BANKHEAD ST
Practice Address - Street 2:
Practice Address - City:NEW ALBANY
Practice Address - State:MS
Practice Address - Zip Code:38652-3319
Practice Address - Country:US
Practice Address - Phone:662-432-0961
Practice Address - Fax:662-432-0965
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-04
Last Update Date:2022-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA390200000X
MS241722080P0205X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0205XAllopathic & Osteopathic PhysiciansPediatricsPediatric Endocrinology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL182068Medicaid
MS04051062Medicaid
MS468076YJ5DMedicare PIN