Healthcare Provider Details

I. General information

NPI: 1033160759
Provider Name (Legal Business Name): PETER E SILVERSMITH MD
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 05/15/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8101 HINSON FARM RD #217
ALEXANDRIA VA
22306-3403
US

IV. Provider business mailing address

8101 HINSON FARM RD #217
ALEXANDRIA VA
22306-3403
US

V. Phone/Fax

Practice location:
  • Phone: 703-780-1150
  • Fax:
Mailing address:
  • Phone: 703-780-1150
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208200000X
TaxonomyPlastic Surgery Physician
License Number0101029057
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: