Provider Demographics
NPI:1427246065
Name:THOMAS E SILVER DPMPA
Entity type:Organization
Organization Name:THOMAS E SILVER DPMPA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:E
Authorized Official - Last Name:SILVER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:952-544-1314
Mailing Address - Street 1:669 WINNETKA AVE N
Mailing Address - Street 2:SUITE 201
Mailing Address - City:GOLDEN VALLEY
Mailing Address - State:MN
Mailing Address - Zip Code:55427
Mailing Address - Country:US
Mailing Address - Phone:952-544-1314
Mailing Address - Fax:763-231-2343
Practice Address - Street 1:669 WINNETKA AVE N
Practice Address - Street 2:SUITE 201
Practice Address - City:GOLDEN VALLEY
Practice Address - State:MN
Practice Address - Zip Code:55427
Practice Address - Country:US
Practice Address - Phone:952-544-1314
Practice Address - Fax:763-231-2343
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-09
Last Update Date:2010-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN349213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN86724SIOtherBCBS
MN101089OtherUCARE
MN973025700Medicaid
MN86724SIOtherBCBS
MN480000003Medicare PIN