Healthcare Provider Details

I. General information

NPI: 1881183028
Provider Name (Legal Business Name): SILVERSTONE MEDICAL GROUP, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/03/2018
Last Update Date: 05/03/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

805 OAKWOOD DR STE 111
ROCHESTER MI
48307-1359
US

IV. Provider business mailing address

805 OAKWOOD DR STE 111
ROCHESTER MI
48307-1359
US

V. Phone/Fax

Practice location:
  • Phone: 734-728-4141
  • Fax:
Mailing address:
  • Phone: 734-728-4141
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number State

VIII. Authorized Official

Name: MICHAEL SILVERSTONE
Title or Position: SOLE OWNER
Credential: DO
Phone: 734-728-4141