Individual
CRYSTAL DAWN SILAS
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
715 DELMORE DR, ROSEAU, MN 56751-1534
(218) 463-2500
Mailing address
1949 E EVERGREEN CT, VISALIA, CA 93292-1499
(559) 288-9004
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
45860
MN
207Q00000X
Family Medicine Physician
46000
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
34444100
—
WI
Enumeration date
05/31/2006
Last updated
07/08/2007
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