1881215283 NPI number — EMIDIO GERMANO DA SILVA NETO MD

Table of content: EMIDIO GERMANO DA SILVA NETO MD (NPI 1881215283)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1881215283 NPI number — EMIDIO GERMANO DA SILVA NETO MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
GERMANO DA SILVA NETO
Provider First Name:
EMIDIO
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1881215283
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/27/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
600 GRESHAM DR STE 8620
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
NORFOLK
Provider Business Mailing Address State Name:
VA
Provider Business Mailing Address Postal Code:
23507-1904
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
757-388-6402
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
600 GRESHAM DR STE 8620
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NORFOLK
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
23507-1904
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
757-388-6402
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
04/27/2020

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 2086S0129X , with the licence number:  0116035063 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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