Basic Information
Provider Information
NPI: 1821056573
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SILBER
FirstName: MICHAEL
MiddleName: S
NamePrefix: DR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 199 PARK CLUB LN STE 300
Address2:  
City: WILLIAMSVILLE
State: NY
PostalCode: 142215269
CountryCode: US
TelephoneNumber: 7168364646
FaxNumber: 7168364696
Practice Location
Address1: 199 PARK CLUB LN STE 300
Address2:  
City: WILLIAMSVILLE
State: NY
PostalCode: 142215269
CountryCode: US
TelephoneNumber: 7168364646
FaxNumber: 7168364696
Other Information
ProviderEnumerationDate: 05/03/2006
LastUpdateDate: 12/17/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 12/17/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
2085R0202X210953NYY Allopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology

ID Information
IDTypeStateIssuerDescription
0004093930201 UNIVERAOTHER
00091679901301 BLUE SHIELD WNYOTHER
101773FF01 PREFERRED CAREOTHER
P0000572401 RR MEDICAREOTHER
014210101 GHIOTHER
P02021095301 ROCHESTER BLUE SHIELDOTHER
00091679901001 BLUE SHIELD WNYOTHER
04042600306801 FIDELISOTHER
2109536B01 WORKERS COMPENSATIONOTHER
0004093930401 UNIVERAOTHER
169315401 INDEPENDENT HEALTHOTHER
410539501 GHIOTHER
0994164305NY MEDICAID
P01021095301 BLUE CHOICEOTHER


Home