Provider Demographics
NPI:1609872159
Name:SILVERMAN, LANCE MICHAEL (MD)
Entity type:Individual
Prefix:
First Name:LANCE
Middle Name:MICHAEL
Last Name:SILVERMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1285 HEMBREE RD STE 200A
Mailing Address - Street 2:
Mailing Address - City:ROSWELL
Mailing Address - State:GA
Mailing Address - Zip Code:30076-4995
Mailing Address - Country:US
Mailing Address - Phone:770-475-2710
Mailing Address - Fax:770-475-0078
Practice Address - Street 1:1285 HEMBREE RD STE 200A
Practice Address - Street 2:
Practice Address - City:ROSWELL
Practice Address - State:GA
Practice Address - Zip Code:30076-4995
Practice Address - Country:US
Practice Address - Phone:770-475-2710
Practice Address - Fax:770-475-0078
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-21
Last Update Date:2024-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN46411207XX0004X
GA100808207XX0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XX0004XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryFoot and Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
200002310OtherMEDICARE PROVIDER NUMBER
MN974832300Medicaid
200002310OtherMEDICARE PROVIDER NUMBER