Provider Demographics
NPI:1306080809
Name:SILVERBERG, BENJAMIN ANDREW (MD)
Entity type:Individual
Prefix:DR
First Name:BENJAMIN
Middle Name:ANDREW
Last Name:SILVERBERG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:390 BIRCH STREET
Mailing Address - Street 2:HEALTH AND EDUCATION BUILDING
Mailing Address - City:MORGANTOWN
Mailing Address - State:WV
Mailing Address - Zip Code:26506-6894
Mailing Address - Country:US
Mailing Address - Phone:304-285-7200
Mailing Address - Fax:
Practice Address - Street 1:390 BIRCH STREET
Practice Address - Street 2:HEALTH AND EDUCATION BUILDING
Practice Address - City:MORGANTOWN
Practice Address - State:WV
Practice Address - Zip Code:26506-6894
Practice Address - Country:US
Practice Address - Phone:304-285-7200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-04-28
Last Update Date:2022-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC01296207Q00000X
CAA134734207Q00000X
WV27144207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA134734OtherCA MEDICAL BOARD
NC01296OtherNC BOARD