Provider Demographics
NPI:1912281767
Name:SILVER, JULIE
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:
Last Name:SILVER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7001 ORCHARD LAKE RD
Mailing Address - Street 2:SUITE 132
Mailing Address - City:WEST BLOOMFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48322-3604
Mailing Address - Country:US
Mailing Address - Phone:248-737-7126
Mailing Address - Fax:
Practice Address - Street 1:7001 ORCHARD LAKE RD
Practice Address - Street 2:SUITE 132
Practice Address - City:WEST BLOOMFIELD
Practice Address - State:MI
Practice Address - Zip Code:48322-3604
Practice Address - Country:US
Practice Address - Phone:248-737-7126
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-28
Last Update Date:2011-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI14228171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
Provider Identifiers
StateIdentifier IDID TypeIssuer
14228OtherBOARD CERTIFICATION