Provider Demographics
NPI:1699862359
Name:SILBERT CHIROPRACTIC CLINIC PC
Entity type:Organization
Organization Name:SILBERT CHIROPRACTIC CLINIC PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:SILBERT
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:734-285-0020
Mailing Address - Street 1:13700 FORT ST
Mailing Address - Street 2:
Mailing Address - City:SOUTHGATE
Mailing Address - State:MI
Mailing Address - Zip Code:48195-1153
Mailing Address - Country:US
Mailing Address - Phone:734-285-0020
Mailing Address - Fax:734-285-0512
Practice Address - Street 1:13700 FORT ST
Practice Address - Street 2:
Practice Address - City:SOUTHGATE
Practice Address - State:MI
Practice Address - Zip Code:48195-1153
Practice Address - Country:US
Practice Address - Phone:734-285-0020
Practice Address - Fax:734-285-0512
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-06
Last Update Date:2011-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301005473111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI443963114Medicaid
MI950H25160OtherBLUE CROSS BLUE SHEILD
MI0H25160595Medicare ID - Type Unspecified
MI950H25160OtherBLUE CROSS BLUE SHEILD