Healthcare Provider Details

I. General information

NPI: 1346231339
Provider Name (Legal Business Name): ELLIOTT C. SILBAR MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/31/2005
Last Update Date: 08/14/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2801 W KINNICKINNIC RIVER PKWY STE 370
MILWAUKEE WI
53215-3669
US

IV. Provider business mailing address

2801 W KINNICKINNIC RIVER PKWY STE 370
MILWAUKEE WI
53215-3669
US

V. Phone/Fax

Practice location:
  • Phone: 414-672-6006
  • Fax: 414-672-6016
Mailing address:
  • Phone: 414-672-6006
  • Fax: 414-672-6016

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208800000X
TaxonomyUrology Physician
License Number27502
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: