=====================================================
General NPI Number Information
=====================================================
NPI Number | 1881696524
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | HENRY R SILVERMAN III MD
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/12/2005
-----------------------------------------------------
Last Update Date | 11/03/2023
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 818 RIVERSIDE AVE 5TH FLOOR CARDIOLOGY
-----------------------------------------------------
City | ADRIAN
-----------------------------------------------------
State | MI
-----------------------------------------------------
Zip | 49221-1446
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 517-265-0214
-----------------------------------------------------
Fax | 517-265-0814
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1 SEAGATE STE 800
-----------------------------------------------------
City | TOLEDO
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 43604-1558
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 517-265-0214
-----------------------------------------------------
Fax | 517-265-0814
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207RC0000X
-----------------------------------------------------
Taxonomy Name | Cardiovascular Disease Physician
-----------------------------------------------------
License Number | 4301048832
-----------------------------------------------------
License Number State | MI
-----------------------------------------------------