Individual
MARYLOU SILVA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PAC
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
PA00235
RI
363AS0400X
Surgical Physician Assistant
Primary
3909
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
275938
BLUECHIP
—
01
—
9003558
RIMEDICALASSISTANCE
—
Enumeration date
10/13/2005
Last updated
07/21/2022
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