Provider Demographics
NPI:1952981367
Name:JAIMES, SILVESTRE (PA-C)
Entity Type:Individual
Prefix:
First Name:SILVESTRE
Middle Name:
Last Name:JAIMES
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2304 TRANQUIL DR SE
Mailing Address - Street 2:
Mailing Address - City:WILSON
Mailing Address - State:NC
Mailing Address - Zip Code:27893-9007
Mailing Address - Country:US
Mailing Address - Phone:252-299-3002
Mailing Address - Fax:
Practice Address - Street 1:2101 W ARLINGTON BLVD STE 210
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:NC
Practice Address - Zip Code:27834-5758
Practice Address - Country:US
Practice Address - Phone:252-752-5000
Practice Address - Fax:252-931-7694
Is Sole Proprietor?:No
Enumeration Date:2021-04-09
Last Update Date:2021-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
363A00000X
NC0010-111822085N0700X, 2085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No2085N0700XAllopathic & Osteopathic PhysiciansRadiologyNeuroradiology