Healthcare Provider Details

I. General information

NPI: 1962492710
Provider Name (Legal Business Name): E H SILVERSTEIN MD PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/24/2005
Last Update Date: 10/26/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4000 OLD COURT RD SUITE 204
BALTIMORE MD
21208-2800
US

IV. Provider business mailing address

4000 OLD COURT RD SUITE 204
BALTIMORE MD
21208-2800
US

V. Phone/Fax

Practice location:
  • Phone: 410-415-5541
  • Fax: 410-415-7352
Mailing address:
  • Phone: 410-415-5541
  • Fax: 410-415-7352

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number
License Number State

VIII. Authorized Official

Name: EMANUEL HENRY SILVERSTEIN
Title or Position: PRESIDENT
Credential: MD
Phone: 410-415-5541