Provider Demographics
NPI:1215749213
Name:SILBERNAGEL, SANDRA ELAINE (RT)
Entity type:Individual
Prefix:
First Name:SANDRA
Middle Name:ELAINE
Last Name:SILBERNAGEL
Suffix:
Gender:F
Credentials:RT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 34
Mailing Address - Street 2:
Mailing Address - City:MCDONOUGH
Mailing Address - State:GA
Mailing Address - Zip Code:30253-0034
Mailing Address - Country:US
Mailing Address - Phone:678-532-3203
Mailing Address - Fax:
Practice Address - Street 1:PO BOX 34
Practice Address - Street 2:
Practice Address - City:MCDONOUGH
Practice Address - State:GA
Practice Address - Zip Code:30253-0034
Practice Address - Country:US
Practice Address - Phone:678-532-3203
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-25
Last Update Date:2025-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA3318372085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology