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General NPI Number Information
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NPI Number | 1043780653
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Entity Type | Individual
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Provider Name | DOUGLAS BENNETT SILVERMAN PSY.D.
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Gender | Male
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Dates
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Enumeration Date | 11/27/2018
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Last Update Date | 12/27/2019
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Provider Practice Location Address
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Address Line | 400 MAIN ST STE 200A-6
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City | HILTON HEAD
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State | SC
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Zip | 29926-4610
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Country | US
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Telephone | 912-417-9541
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Fax |
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Provider Business Mailing Address
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Address Line | 101 BLUE MOON XING # 252
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City | POOLER
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State | GA
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Zip | 31322-9797
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Country | US
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Telephone | 912-450-0594
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PSY004255
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License Number State | GA
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