MEDICARE: SILVERSTONE MEDICAL GROUP, PLLC

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	208D00000X	General Practice Physician

General Provider Information

NPI Number	:	1881183028
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SILVERSTONE MEDICAL GROUP, PLLC

Provider Business Mailing Address
First Line	:	805 OAKWOOD DR STE 111
Second Line	:
City	:	ROCHESTER
State	:	MI
Zip	:	48307-1359
Country	:	US
Telephone Number	:	734-728-4141
Fax Number	:

Provider Business Practice Location Address
First Line	:	805 OAKWOOD DR STE 111
Second Line	:
City	:	ROCHESTER
State	:	MI
Zip	:	48307-1359
Country	:	US
Telephone Number	:	734-728-4141
Fax Number	:

Authorized Official
Title or Position	:	SOLE OWNER
Name	:	MICHAEL SILVERSTONE
Credential	:	DO
Telephone Number	:	734-728-4141

Provider Enumeration Date	:	05/03/2018
Last Update Date	:	05/03/2018

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