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NPI Code Detail

MEDICARE: JEFFREY J SKOVRONSKY MD

MEDICARE: JEFFREY J SKOVRONSKY MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207ZP0102XAnatomic Pathology & Clinical Pathology Physician0101026587VA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
11063438091OTHERGROUP NPI
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1417958299
Entity Type Code : Individual
Provider Name (Legal Business Name) : JEFFREY J SKOVRONSKY MD
Provider Business Mailing Address
First Line : PO BOX 221322
Second Line :
City : CHANTILLY
State : VA
Zip : 20153-1322
Country : US
Telephone Number : 703-691-2516
Fax Number : 703-691-3526
Provider Business Practice Location Address
First Line : 8700 SUDLEY RD
Second Line :
City : MANASSAS
State : VA
Zip : 20110-4418
Country : US
Telephone Number : 703-369-8484
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/03/2005
Last Update Date : 01/24/2009

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Directions to “ JEFFREY J SKOVRONSKY MD” Practice Location

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