Healthcare Provider Details

I. General information

NPI: 1659315570
Provider Name (Legal Business Name): GLENN MICHAEL SILBER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/15/2006
Last Update Date: 06/25/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10025 GOVERNOR WARFIELD PKWY SUITE 410
COLUMBIA MD
21044-3340
US

IV. Provider business mailing address

PO BOX 64264
BALTIMORE MD
21264-4264
US

V. Phone/Fax

Practice location:
  • Phone: 410-730-6000
  • Fax: 443-979-7944
Mailing address:
  • Phone:
  • Fax: 443-979-7944

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207K00000X
TaxonomyAllergy & Immunology Physician
License NumberM24338
License Number StateMD
# 2
Primary TaxonomyY
Taxonomy Code207K00000X
TaxonomyAllergy & Immunology Physician
License NumberD33273
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: