Provider Demographics
NPI:1881183028
Name:SILVERSTONE MEDICAL GROUP, PLLC
Entity Type:Organization
Organization Name:SILVERSTONE MEDICAL GROUP, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:SILVERSTONE
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:734-728-4141
Mailing Address - Street 1:805 OAKWOOD DR STE 111
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:MI
Mailing Address - Zip Code:48307-1359
Mailing Address - Country:US
Mailing Address - Phone:734-728-4141
Mailing Address - Fax:
Practice Address - Street 1:805 OAKWOOD DR STE 111
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:MI
Practice Address - Zip Code:48307-1359
Practice Address - Country:US
Practice Address - Phone:734-728-4141
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-05-03
Last Update Date:2018-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty