Healthcare Provider Details

I. General information

NPI: 1386068153
Provider Name (Legal Business Name): JAMES SILVA CNIM
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: INNERVATE NEUROPHYSIOLOGY

II. Dates (important events)

Enumeration Date: 02/13/2014
Last Update Date: 01/28/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6400 BALTIMORE NATIONAL PIKE #348
BALTIMORE MD
21228-3930
US

IV. Provider business mailing address

6400 BALTIMORE NATIONAL PIKE #348
BALTIMORE MD
21228-3930
US

V. Phone/Fax

Practice location:
  • Phone: 202-670-8843
  • Fax:
Mailing address:
  • Phone: 202-670-8843
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code246ZE0500X
TaxonomyEEG Specialist/Technologist
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code246ZE0600X
TaxonomyElectroneurodiagnostic Specialist/Technologist
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code246ZS0410X
TaxonomySurgical Technologist
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: