Provider Demographics
NPI:1851558621
Name:SILVERMAN, STEFAN G
Entity Type:Individual
Prefix:MR
First Name:STEFAN
Middle Name:G
Last Name:SILVERMAN
Suffix:
Gender:M
Credentials:
Other - Prefix:MRS
Other - First Name:LINDA
Other - Middle Name:H
Other - Last Name:SILVERMAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:OTR/L
Mailing Address - Street 1:2917 133RD ST W
Mailing Address - Street 2:
Mailing Address - City:SHAKOPEE
Mailing Address - State:MN
Mailing Address - Zip Code:55379-9222
Mailing Address - Country:US
Mailing Address - Phone:952-746-3000
Mailing Address - Fax:952-400-1142
Practice Address - Street 1:2917 133RD ST W
Practice Address - Street 2:
Practice Address - City:SHAKOPEE
Practice Address - State:MN
Practice Address - Zip Code:55379-9222
Practice Address - Country:US
Practice Address - Phone:952-746-3000
Practice Address - Fax:952-400-1142
Is Sole Proprietor?:No
Enumeration Date:2008-05-20
Last Update Date:2008-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN20627475171WH0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171WH0202XOther Service ProvidersContractorHome Modifications