Healthcare Provider Details

I. General information

NPI: 1194352302
Provider Name (Legal Business Name): LARISSA SPAGNOL SILVERMAN MD, MPH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/26/2020
Last Update Date: 07/10/2024
Certification Date: 05/22/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9000 FRANKLIN SQUARE DR
BALTIMORE MD
21237-3901
US

IV. Provider business mailing address

1 GUSTAVE L LEVY PL # 1149
NEW YORK NY
10029-6504
US

V. Phone/Fax

Practice location:
  • Phone: 434-777-7000
  • Fax:
Mailing address:
  • Phone: 212-824-8069
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberD0101105
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: