Healthcare Provider Details

I. General information

NPI: 1053350710
Provider Name (Legal Business Name): FREDERICK M. SILVER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/06/2006
Last Update Date: 05/06/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2451 FILLINGIM ST MASTIN 101
MOBILE AL
36617-2238
US

IV. Provider business mailing address

PO BOX 40480
MOBILE AL
36640-0480
US

V. Phone/Fax

Practice location:
  • Phone: 251-445-8282
  • Fax: 251-445-8281
Mailing address:
  • Phone: 251-445-8282
  • Fax: 251-445-8281

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License Number16187
License Number StateAL
# 2
Primary TaxonomyY
Taxonomy Code207YX0007X
TaxonomyPlastic Surgery within the Head & Neck (Otolaryngology) Physician
License Number16187
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: