Healthcare Provider Details

I. General information

NPI: 1700835014
Provider Name (Legal Business Name): MICHAEL JOSEPH SILVERGLAT MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/06/2006
Last Update Date: 09/30/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

910 BROOKS ST SUITE 202
MISSOULA MT
59801-5783
US

IV. Provider business mailing address

3114 MARTINWOOD RD SUITE 202
MISSOULA MT
59802-3263
US

V. Phone/Fax

Practice location:
  • Phone: 406-541-8060
  • Fax: 406-541-8062
Mailing address:
  • Phone: 406-541-8060
  • Fax: 406-541-8062

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number5005
License Number StateMT
# 2
Primary TaxonomyN
Taxonomy Code2084P0805X
TaxonomyGeriatric Psychiatry Physician
License Number5005
License Number StateMT
# 3
Primary TaxonomyY
Taxonomy Code2084S0012X
TaxonomySleep Medicine (Psychiatry & Neurology) Physician
License Number5005
License Number StateMT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: