Provider Demographics
NPI:1407001217
Name:SILVA, MILTON N (PHD)
Entity type:Individual
Prefix:MR
First Name:MILTON
Middle Name:N
Last Name:SILVA
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1238 S CESAR E CHAVEZ DR
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53204-2267
Mailing Address - Country:US
Mailing Address - Phone:414-645-6665
Mailing Address - Fax:414-645-6732
Practice Address - Street 1:1238 S CESAR E CHAVEZ DR
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53204-2267
Practice Address - Country:US
Practice Address - Phone:414-645-6665
Practice Address - Fax:414-645-6732
Is Sole Proprietor?:No
Enumeration Date:2008-11-20
Last Update Date:2008-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI647103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WIP21480Medicare UPIN