Healthcare Provider Details

I. General information

NPI: 1669457644
Provider Name (Legal Business Name): GORDON STANLEY SILVER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/13/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2222 N NEVADA AVE SUITE 4003
COLORADO SPRINGS CO
80907-6819
US

IV. Provider business mailing address

2222 N NEVADA AVE SUITE 4003
COLORADO SPRINGS CO
80907-6819
US

V. Phone/Fax

Practice location:
  • Phone: 719-633-5797
  • Fax: 719-633-1905
Mailing address:
  • Phone: 719-633-5797
  • Fax: 719-633-1905

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License Number23801
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: