Provider Demographics
NPI:1295737302
Name:SILVERMAN, LEONARD S (OD)
Entity type:Individual
Prefix:DR
First Name:LEONARD
Middle Name:S
Last Name:SILVERMAN
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2080 HAMILTON RD
Mailing Address - Street 2:
Mailing Address - City:OKEMOS
Mailing Address - State:MI
Mailing Address - Zip Code:48864-2105
Mailing Address - Country:US
Mailing Address - Phone:517-349-8888
Mailing Address - Fax:
Practice Address - Street 1:2080 HAMILTON RD
Practice Address - Street 2:
Practice Address - City:OKEMOS
Practice Address - State:MI
Practice Address - Zip Code:48864-2105
Practice Address - Country:US
Practice Address - Phone:517-349-8888
Practice Address - Fax:517-349-1788
Is Sole Proprietor?:No
Enumeration Date:2005-06-02
Last Update Date:2014-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4901003031152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIU21808Medicare UPIN
MIOC36504Medicare ID - Type Unspecified