Healthcare Provider Details

I. General information

NPI: 1952309635
Provider Name (Legal Business Name): RICHARD A SILVA M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/07/2005
Last Update Date: 04/14/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20410 OBSERVATION DR SUITE 100
GERMANTOWN MD
20876-4000
US

IV. Provider business mailing address

20410 OBSERVATION DR SUITE 100
GERMANTOWN MD
20876-4000
US

V. Phone/Fax

Practice location:
  • Phone: 301-330-1000
  • Fax: 301-330-9108
Mailing address:
  • Phone: 301-330-1000
  • Fax: 301-330-9108

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2086S0129X
TaxonomyVascular Surgery Physician
License NumberD53864
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: