MEDICARE: DR. MARK F SILADY M.D.

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	207PE0005X	Undersea and Hyperbaric Medicine (Emergency Medicine) Physician	MD08818R	LA
2	207P00000X	Emergency Medicine Physician	MD.08818R	LA

General Provider Information

NPI Number	:	1609832641
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MARK F SILADY M.D.

Provider Business Mailing Address
First Line	:	1514 JEFFERSON HWY
Second Line	:
City	:	NEW ORLEANS
State	:	LA
Zip	:	70121-2429
Country	:	US
Telephone Number	:	504-842-4000
Fax Number	:

Provider Business Practice Location Address
First Line	:	3600 FLORIDA BLVD
Second Line	:	ADVANCED WOUND CARE CENTER
City	:	BATON ROUGE
State	:	LA
Zip	:	70806-3842
Country	:	US
Telephone Number	:	225-387-7818
Fax Number	:

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

Provider Enumeration Date	:	04/26/2006
Last Update Date	:	04/11/2017

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