Provider Demographics
NPI:1801899141
Name:SILVERMAN, RALPH (MD)
Entity type:Individual
Prefix:DR
First Name:RALPH
Middle Name:
Last Name:SILVERMAN
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 1:12345 WEST BEND DRIVE
Mailing Address - Street 2:SUITE 303
Mailing Address - City:ST. LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63128
Mailing Address - Country:US
Mailing Address - Phone:314-849-1811
Mailing Address - Fax:314-849-7470
Practice Address - Street 1:12345 WEST BEND DR.
Practice Address - Street 2:SUITE 303
Practice Address - City:ST. LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63128
Practice Address - Country:US
Practice Address - Phone:314-849-1811
Practice Address - Fax:314-849-7470
Is Sole Proprietor?:No
Enumeration Date:2005-05-31
Last Update Date:2021-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO115610208C00000X
MOMD115610208C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208C00000XAllopathic & Osteopathic PhysiciansColon & Rectal Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO207535204Medicaid
MOI08442Medicare UPIN