Healthcare Provider Details

I. General information

NPI: 1487646543
Provider Name (Legal Business Name): RICHARD STANLEY SILVER D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/16/2005
Last Update Date: 01/17/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11890 KINSMAN RD
NEWBURY OH
44065-9690
US

IV. Provider business mailing address

11890 KINSMAN RD PO BOX 382
NEWBURY OH
44065-0382
US

V. Phone/Fax

Practice location:
  • Phone: 440-832-7009
  • Fax: 440-273-3143
Mailing address:
  • Phone: 440-832-7009
  • Fax: 440-273-3143

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QA0401X
TaxonomyAddiction Medicine (Family Medicine) Physician
License Number34-00-2391-S
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: