Healthcare Provider Details

I. General information

NPI: 1508320367
Provider Name (Legal Business Name): TODD B. SILVERMAN MD, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/25/2019
Last Update Date: 02/19/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14825 NORTH OUTER 40 RD STE 330-B
CHESTERFIELD MO
63017-2119
US

IV. Provider business mailing address

14825 NORTH OUTER 40 RD STE 330-B
CHESTERFIELD MO
63017-2119
US

V. Phone/Fax

Practice location:
  • Phone: 636-537-0525
  • Fax: 636-537-0575
Mailing address:
  • Phone: 636-537-0525
  • Fax: 636-537-0575

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2084N0600X
TaxonomyClinical Neurophysiology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. TODD SILVERMAN
Title or Position: OWNER/PHYSICIAN
Credential: MD
Phone: 636-537-0525