Provider Demographics
NPI:1124086053
Name:SILVERMAN SHEPARD, SHARON L (MD)
Entity type:Individual
Prefix:
First Name:SHARON
Middle Name:L
Last Name:SILVERMAN SHEPARD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:SHARON
Other - Middle Name:L
Other - Last Name:SILVERMAN,
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:345 BLACKSTONE BLVD
Mailing Address - Street 2:
Mailing Address - City:PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02906-4800
Mailing Address - Country:US
Mailing Address - Phone:401-455-6200
Mailing Address - Fax:401-455-6293
Practice Address - Street 1:345 BLACKSTONE BLVD
Practice Address - Street 2:
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02906-4800
Practice Address - Country:US
Practice Address - Phone:401-455-6200
Practice Address - Fax:401-455-6293
Is Sole Proprietor?:No
Enumeration Date:2006-05-02
Last Update Date:2008-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2057162084P0800X
RIMD101922084P0804X, 2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI409611OtherBLUE CHIP
RI1104801349OtherBUTLER HOSPITAL NPI
RI15-55156OtherUNITED BEHAVIORAL HEALTH
RI30045-6OtherBLUE CROSS
1093831646OtherBUTLER HOSPITAL PROFESSIONAL BILLING OFFICE
RI7009877Medicaid
RI409611OtherBLUE CHIP
RIH63213Medicare UPIN