Provider Demographics
NPI:1942213004
Name:SILVA, JOAQUIN JAIME (MD)
Entity Type:Individual
Prefix:DR
First Name:JOAQUIN
Middle Name:JAIME
Last Name:SILVA
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 1:1 VETERANS DRIVE
Mailing Address - Street 2:MINNEAPOLIS VA MEDICAL CTR
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55417
Mailing Address - Country:US
Mailing Address - Phone:612-725-2133
Mailing Address - Fax:612-727-5973
Practice Address - Street 1:1 VETERANS DRIVE
Practice Address - Street 2:MINNEAPOLIS VA MEDICAL CTR
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55417
Practice Address - Country:US
Practice Address - Phone:612-725-2133
Practice Address - Fax:612-727-5973
Is Sole Proprietor?:No
Enumeration Date:2006-08-13
Last Update Date:2007-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN454852085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
H20818Medicare UPIN