MEDICARE: ALAN B SILVERBERG 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	207RE0101X	Endocrinology, Diabetes & Metabolism Physician	R6076	MO

General Provider Information

NPI Number	:	1972511848
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALAN B SILVERBERG MD

Provider Business Mailing Address
First Line	:	3691 RUTGER ST
Second Line	:	PROVIDER ENROLLMENT
City	:	SAINT LOUIS
State	:	MO
Zip	:	63110-2515
Country	:	US
Telephone Number	:	314-977-4440
Fax Number	:

Provider Business Practice Location Address
First Line	:	3660 VISTA AVE
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63110-2540
Country	:	US
Telephone Number	:	314-977-6157
Fax Number	:	314-977-5177

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

Provider Enumeration Date	:	08/04/2006
Last Update Date	:	03/18/2008

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