Provider Demographics
NPI:1447264031
Name:SILVER, THOMAS E (DPM)
Entity type:Individual
Prefix:
First Name:THOMAS
Middle Name:E
Last Name:SILVER
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2608 PRINCETON AVE
Mailing Address - Street 2:
Mailing Address - City:ST LOUIS PARK
Mailing Address - State:MN
Mailing Address - Zip Code:55416-1980
Mailing Address - Country:US
Mailing Address - Phone:952-544-1314
Mailing Address - Fax:
Practice Address - Street 1:669 WINNETKA AVE N STE 201
Practice Address - Street 2:
Practice Address - City:GOLDEN VALLEY
Practice Address - State:MN
Practice Address - Zip Code:55427-4576
Practice Address - Country:US
Practice Address - Phone:952-544-1314
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-28
Last Update Date:2017-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332B00000X
MN349213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN480000575OtherRR MEDICARE
MN2780010OtherMEDICA
MN00789001OtherPREFERRED ONE
MN101089OtherUCARE
MN973025700Medicaid
MNHP39668OtherHEALTH PARTNERS
MN2725104OtherMEDICA CHOICE
MN86724SIOtherBCBS
MN0277050001OtherADMINISTAR
MN86724SIOtherBCBS