Provider Demographics
NPI:1831176353
Name:DA SILVA, MARTA H (MD)
Entity type:Individual
Prefix:MRS
First Name:MARTA
Middle Name:H
Last Name:DA SILVA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:13100 MANCHESTER RD STE 150
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63131-1743
Mailing Address - Country:US
Mailing Address - Phone:314-692-7886
Mailing Address - Fax:314-692-7929
Practice Address - Street 1:13100 MANCHESTER RD STE 150
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63131-1743
Practice Address - Country:US
Practice Address - Phone:314-692-7886
Practice Address - Fax:314-692-7929
Is Sole Proprietor?:No
Enumeration Date:2005-12-27
Last Update Date:2017-11-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MO1018902084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO206981615Medicaid
MO206981615Medicaid