| |
14825 North Outer 40 Rd Ste 330-b Chesterfield MO 63017-2119 | |
(636) 537-0525 | |
(636) 537-0575 |
Full Name | |
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Speciality | Psychiatry & Neurology |
Location | 14825 North Outer 40 Rd Ste 330-b, Chesterfield, Missouri |
Authorized Official Name and Position | Todd Silverman (OWNER/PHYSICIAN) |
Authorized Official Contact | 6365370525 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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14825 North Outer 40 Rd Ste 330-b Chesterfield MO 63017-2119 Ph: (636) 537-0525 | 14825 North Outer 40 Rd Ste 330-b Chesterfield MO 63017-2119 Ph: (636) 537-0525 |
NPI Number | 1508320367 |
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Provider Enumeration Date | 01/25/2019 |
Last Update Date | 02/19/2019 |
Medicare PECOS PAC ID | 0941547111 |
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Medicare Enrollment ID | O20190125000847 |
Identifier | Type | State | Issuer |
---|---|---|---|
1508320367 | NPI | - | NPPES |
1114016391 | Other | MO | INDIVIDUAL NPI |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
2084N0400X | Psychiatry & Neurology - Neurology | (* (Not Available)) | Primary |
2084N0600X | Psychiatry & Neurology - Clinical Neurophysiology | (* (Not Available)) | Secondary |
Provider Name | Todd B Silverman |
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Provider Type | Practitioner - Neurology |
Provider Identifiers | NPI Number: 1114016391 PECOS PAC ID: 8426130972 Enrollment ID: I20080123000647 |
Provider Name | Richard B Sommerville |
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Provider Type | Practitioner - Neurology |
Provider Identifiers | NPI Number: 1053529164 PECOS PAC ID: 9931233673 Enrollment ID: I20100817000171 |
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