MEDICARE: IRIS SILVERSTEIN MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208000000X	Pediatrics Physician	221062	MA
2	208000000X	Pediatrics Physician	011132	ME

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	J28265	OTHER	MA	BCBS

General Provider Information

NPI Number	:	1295792968
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	IRIS SILVERSTEIN MD

Provider Business Mailing Address
First Line	:	111 FRANKLIN HEALTH CMNS
Second Line	:
City	:	FARMINGTON
State	:	ME
Zip	:	04938-6144
Country	:	US
Telephone Number	:	207-779-6623
Fax Number	:	207-779-2323

Provider Business Practice Location Address
First Line	:	131 FRANKLIN HEALTH CMNS
Second Line	:	FRANKLIN HLTH CHILD & ADOL. DEVELOPMENTAL PEDIATRICS
City	:	FARMINGTON
State	:	ME
Zip	:	04938-6142
Country	:	US
Telephone Number	:	207-779-6623
Fax Number	:	207-779-2323

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/27/2006
Last Update Date	:	01/24/2012

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Directions to “ IRIS SILVERSTEIN MD” Practice Location

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