Basic Information
| Provider Information | |||||||||
| NPI: | 1568428043 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SILE | ||||||||
| FirstName: | CYNTHIA | ||||||||
| MiddleName: | CHAN | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 6350 CENTER DR | ||||||||
| Address2: | STE 200 | ||||||||
| City: | NORFOLK | ||||||||
| State: | VA | ||||||||
| PostalCode: | 235024107 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7572135700 | ||||||||
| FaxNumber: | 7572135762 | ||||||||
| Practice Location | |||||||||
| Address1: | 150 BURNETTS WAY | ||||||||
| Address2: | SUITE 310 | ||||||||
| City: | SUFFOLK | ||||||||
| State: | VA | ||||||||
| PostalCode: | 234348168 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7575390670 | ||||||||
| FaxNumber: | 7575391062 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/25/2006 | ||||||||
| LastUpdateDate: | 06/19/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RH0003X | MD073324L | PA | N | Allopathic & Osteopathic Physicians | Internal Medicine | Hematology & Oncology | 207RH0003X | 0101058600 | VA | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Hematology & Oncology |
ID Information
| ID | Type | State | Issuer | Description | 5767724 | 01 | PA | AETNA PPOS | OTHER | 1304723 | 01 | HIGHMARK | OTHER | 900003731 | 01 | RAILROAD MEDICARE | OTHER | 000000198810 | 01 | OH | ANTHEM | OTHER | 000000119810 | 01 | UNISON/MEDPLUS | OTHER | 0018579320001 | 05 | PA | MEDICAID | 2295672 | 05 | OH | MEDICAID | 0018579320002 | 05 | PA | MEDICAID | 1568428043 | 01 | VA | OPTIMA | OTHER | 3340403 | 01 | PA | AETNA | OTHER | 1568428043 | 05 | VA | MEDICAID |