Provider Demographics
NPI:1962586065
Name:SILVERMAN, EDWARD RAY (MD)
Entity type:Individual
Prefix:DR
First Name:EDWARD
Middle Name:RAY
Last Name:SILVERMAN
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 1:843 PARK AVENUE LOWER
Mailing Address - Street 2:
Mailing Address - City:NORTH TONAWANDA
Mailing Address - State:NY
Mailing Address - Zip Code:14120
Mailing Address - Country:US
Mailing Address - Phone:713-695-3756
Mailing Address - Fax:
Practice Address - Street 1:900 ROCKMEAD DRIVE
Practice Address - Street 2:SUITE 274
Practice Address - City:KINGWOOD
Practice Address - State:TX
Practice Address - Zip Code:77339
Practice Address - Country:US
Practice Address - Phone:800-759-8203
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-25
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY221741-12085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAMD418214OtherMEDICAL LICENSE
NY221741-1OtherMEDICAL LICENSE
IA35184OtherMEDICAL LICENSE
WI45225-020OtherMEDICAL LICENSE
MT46107OtherMEDICAL LICENSE
OH35.086520OtherMEDICAL LICENSE
DCBS8211017OtherDEA NUMBER
PAMD418214OtherMEDICAL LICENSE