Provider Demographics
NPI:1821028408
Name:SILVERBERG, DEAN (DO)
Entity Type:Individual
Prefix:
First Name:DEAN
Middle Name:
Last Name:SILVERBERG
Suffix:
Gender:M
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:NORTH FLORIDA/SOUTH GEORGIA VETERANS HEALTH SYSTEM
Mailing Address - Street 2:619 SOUTH MARION AVENUE
Mailing Address - City:LAKE CITY
Mailing Address - State:FL
Mailing Address - Zip Code:32025
Mailing Address - Country:US
Mailing Address - Phone:386-755-3016
Mailing Address - Fax:386-758-6008
Practice Address - Street 1:NORTH FLORIDA/SOUTH GEORGIA VETERANS HEALTH SYSTEM
Practice Address - Street 2:619 SOUTH MARION AVENUE
Practice Address - City:LAKE CITY
Practice Address - State:FL
Practice Address - Zip Code:32025
Practice Address - Country:US
Practice Address - Phone:386-755-3016
Practice Address - Fax:386-758-6008
Is Sole Proprietor?:No
Enumeration Date:2006-07-03
Last Update Date:2010-10-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLOS5504207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000784803GMedicaid
GA005276OtherBLUE CROSS
GA000784803GMedicaid
GA005276OtherBLUE CROSS