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NPI Code Detail

MEDICARE: SILVERTON GROUP LLC

MEDICARE: SILVERTON GROUP LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208M00000XHospitalist Physician

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1629303169
Entity Type Code : Organization
Provider Name (Legal Business Name) : SILVERTON GROUP LLC
Provider Business Mailing Address
First Line : PO BOX 1249
Second Line :
City : BOUNTIFUL
State : UT
Zip : 84011-1249
Country : US
Telephone Number : 801-296-2113
Fax Number : 801-296-1715
Provider Business Practice Location Address
First Line : 4252 S BIRKHILL BLVD
Second Line :
City : MURRAY
State : UT
Zip : 84107-5715
Country : US
Telephone Number : 385-425-0050
Fax Number : 801-951-2389
Authorized Official
Title or Position : MANAGING PARTNER
Name : MARK L MARTINEZ
Credential : MD
Telephone Number : 801-350-4110
Provider Enumeration Date : 10/15/2009
Last Update Date : 09/19/2019

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Directions to “SILVERTON GROUP LLC ” Practice Location

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