Provider Demographics
NPI:1801035779
Name:SILVER, MARTINE TAMARA (MD)
Entity Type:Individual
Prefix:
First Name:MARTINE
Middle Name:TAMARA
Last Name:SILVER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:5650 STONE CROSSING DR
Mailing Address - Street 2:
Mailing Address - City:WINSTON SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27104-3747
Mailing Address - Country:US
Mailing Address - Phone:267-257-8756
Mailing Address - Fax:
Practice Address - Street 1:3333 SILAS CREEK PKWY
Practice Address - Street 2:
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27103-3013
Practice Address - Country:US
Practice Address - Phone:800-899-5757
Practice Address - Fax:314-821-1833
Is Sole Proprietor?:No
Enumeration Date:2009-02-16
Last Update Date:2021-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2011-01172207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC5917871Medicaid
NCNC0751AMedicare PIN