Individual
MICHAELA O. SILCO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
100 FODEN RD, EAST, SUITE 203, SOUTH PORTLAND, ME 04106-2327
(207) 874-1489
(207) 523-8590
Mailing address
100 GANNETT DRIVE, SUITE C, SOUTH PORTLAND, ME 04106-5900
(207) 828-0361
(207) 874-1483
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
DO2430
ME
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1114212149
—
ME
Enumeration date
06/17/2011
Last updated
09/26/2018
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