MEDICARE: MANSUETO SILVERMAN 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	207R00000X	Internal Medicine Physician	010357001	IN

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	110234218	OTHER	IN	MEDICARE RR

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1730184466
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MANSUETO SILVERMAN M.D.

Provider Business Mailing Address
First Line	:	PO BOX 1134
Second Line	:
City	:	CROWN POINT
State	:	IN
Zip	:	46308-1134
Country	:	US
Telephone Number	:	219-662-3931
Fax Number	:	219-663-6359

Provider Business Practice Location Address
First Line	:	9006 INDIANAPOLIS BLVD
Second Line	:
City	:	HIGHLAND
State	:	IN
Zip	:	46322-2501
Country	:	US
Telephone Number	:	219-923-2241
Fax Number	:	219-838-3455

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

Provider Enumeration Date	:	06/17/2005
Last Update Date	:	08/01/2017

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Directions to “ MANSUETO SILVERMAN M.D.” Practice Location

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