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Individual

KEYONNA NICKARA SILVA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
D.O.

Contact information

Practice address
14090 HG TRUEMAN RD, SUITE 2100, SOLOMONS, MD 20688-3151
(410) 394-3712
(410) 394-3714
Mailing address
100 HOSPITAL RD, ATT: CONTRACT & CREDENTIALING COORD., PRINCE FREDERICK, MD 20678-4017
(410) 414-4791
(410) 414-4558

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
H0081227
MD
207Q00000X
Family Medicine Physician
OT015019
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
110222200
MD
Enumeration date
05/28/2013
Last updated
06/21/2022
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