Provider Demographics
NPI:1649265364
Name:SILVERSTEIN, SETH (MD)
Entity type:Individual
Prefix:MR
First Name:SETH
Middle Name:
Last Name:SILVERSTEIN
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 1:4625 BEAU LAC LANE
Mailing Address - Street 2:
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70002-1452
Mailing Address - Country:US
Mailing Address - Phone:504-451-3232
Mailing Address - Fax:504-455-6214
Practice Address - Street 1:4625 BEAU LAC LANE
Practice Address - Street 2:
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70002-1452
Practice Address - Country:US
Practice Address - Phone:504-455-6214
Practice Address - Fax:504-455-6214
Is Sole Proprietor?:No
Enumeration Date:2005-09-19
Last Update Date:2015-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAMD07544R2085B0100X
LAMD.07544R208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
No2085B0100XAllopathic & Osteopathic PhysiciansRadiologyBody Imaging
Provider Identifiers
StateIdentifier IDID TypeIssuer
20658100OtherFLEX (USMLE)
LA1373958Medicaid
LA54098Medicare ID - Type Unspecified
LA54098F340Medicare Oscar/Certification
LA1373958Medicaid