Provider Demographics
NPI:1902817505
Name:SILAPASWAN, SUMET (MD)
Entity Type:Individual
Prefix:
First Name:SUMET
Middle Name:
Last Name:SILAPASWAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26850 PROVIDENCE PKWY
Mailing Address - Street 2:STE 504
Mailing Address - City:NOVI
Mailing Address - State:MI
Mailing Address - Zip Code:48374-1267
Mailing Address - Country:US
Mailing Address - Phone:248-646-4333
Mailing Address - Fax:248-662-3022
Practice Address - Street 1:26850 PROVIDENCE PKWY STE 504
Practice Address - Street 2:
Practice Address - City:NOVI
Practice Address - State:MI
Practice Address - Zip Code:48374-1267
Practice Address - Country:US
Practice Address - Phone:248-646-4333
Practice Address - Fax:248-662-3022
Is Sole Proprietor?:No
Enumeration Date:2006-08-10
Last Update Date:2019-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MISS033649208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0206330281OtherBCN
MI0206330281OtherBCBS
MI2994257Medicaid
MI105432OtherGREAT LAKES
MI06330286021Medicare ID - Type Unspecified
MI2994257Medicaid
MIMI1272001Medicare PIN