Provider Demographics
NPI:1396744405
Name:SILLAMAN, JAMES W III (DO)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:W
Last Name:SILLAMAN
Suffix:III
Gender:M
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:555 ROUTE 217
Mailing Address - Street 2:SUITE 5
Mailing Address - City:LATROBE
Mailing Address - State:PA
Mailing Address - Zip Code:15650-3484
Mailing Address - Country:US
Mailing Address - Phone:724-694-0272
Mailing Address - Fax:724-694-0383
Practice Address - Street 1:555 ROUTE 217
Practice Address - Street 2:SUITE 5
Practice Address - City:LATROBE
Practice Address - State:PA
Practice Address - Zip Code:15650-3484
Practice Address - Country:US
Practice Address - Phone:724-694-0272
Practice Address - Fax:724-694-0383
Is Sole Proprietor?:No
Enumeration Date:2005-07-20
Last Update Date:2008-01-23
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Provider Licenses
StateLicense IDTaxonomies
PAOS0003007L207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0006624540004Medicaid
PA0006624540004Medicaid
PAC28387Medicare UPIN