Healthcare Provider Details

I. General information

NPI: 1326203308
Provider Name (Legal Business Name): DANIEL CHARLES SKIRVIN DVM
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/18/2008
Last Update Date: 07/18/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8996 W UNION HILLS DR SUITE 107
PEORIA AZ
85382-3010
US

IV. Provider business mailing address

8996 W UNION HILLS DR SUITE 107
PEORIA AZ
85382-3010
US

V. Phone/Fax

Practice location:
  • Phone: 623-825-9170
  • Fax:
Mailing address:
  • Phone: 623-825-9170
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174M00000X
TaxonomyVeterinarian
License Number4465
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: