=====================================================
General NPI Number Information
=====================================================
NPI Number | 1457479008
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | ROMULO EDWARD SILVA MD MPH
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/26/2007
-----------------------------------------------------
Last Update Date | 07/08/2007
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1027 E CAMELBACK RD
-----------------------------------------------------
City | PHOENIX
-----------------------------------------------------
State | AZ
-----------------------------------------------------
Zip | 85014
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 602-265-4357
-----------------------------------------------------
Fax | 602-265-9352
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 9209 E EMERALD DRIVE
-----------------------------------------------------
City | SUN LAKES
-----------------------------------------------------
State | AZ
-----------------------------------------------------
Zip | 85248
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 480-802-4260
-----------------------------------------------------
Fax | 480-802-4258
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207Q00000X
-----------------------------------------------------
Taxonomy Name | Family Medicine Physician
-----------------------------------------------------
License Number | 8687
-----------------------------------------------------
License Number State | AZ
-----------------------------------------------------