Provider Demographics
NPI:1922000769
Name:SILVA, GEORGE JOSEPH
Entity Type:Individual
Prefix:
First Name:GEORGE
Middle Name:JOSEPH
Last Name:SILVA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 INDUSTRIAL DR
Mailing Address - Street 2:SUITE 100
Mailing Address - City:MASHPEE
Mailing Address - State:MA
Mailing Address - Zip Code:02649-3464
Mailing Address - Country:US
Mailing Address - Phone:508-477-4282
Mailing Address - Fax:508-539-6134
Practice Address - Street 1:5 INDUSTRIAL DR
Practice Address - Street 2:SUITE 100
Practice Address - City:MASHPEE
Practice Address - State:MA
Practice Address - Zip Code:02649-3464
Practice Address - Country:US
Practice Address - Phone:508-477-4282
Practice Address - Fax:508-539-6134
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-11
Last Update Date:2010-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA51965207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
B74341Medicare UPIN
M15825Medicare ID - Type Unspecified
MA9771492Medicare ID - Type Unspecified