Provider Demographics
NPI:1174617682
Name:CHEYENNE CARDIOVASCULAR & THORACIC SURGERY
Entity type:Organization
Organization Name:CHEYENNE CARDIOVASCULAR & THORACIC SURGERY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:GARY
Authorized Official - Last Name:SILVER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:307-638-6624
Mailing Address - Street 1:2301 HOUSE AVE
Mailing Address - Street 2:SUITE 207
Mailing Address - City:CHEYENNE
Mailing Address - State:WY
Mailing Address - Zip Code:82001
Mailing Address - Country:US
Mailing Address - Phone:307-638-6624
Mailing Address - Fax:307-778-8229
Practice Address - Street 1:2301 HOUSE AVE
Practice Address - Street 2:SUITE 207
Practice Address - City:CHEYENNE
Practice Address - State:WY
Practice Address - Zip Code:82001
Practice Address - Country:US
Practice Address - Phone:307-638-6624
Practice Address - Fax:307-778-8229
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WYW308371Medicare ID - Type Unspecified