Healthcare Provider Details

I. General information

NPI: 1518994607
Provider Name (Legal Business Name): STEPHEN D. SKJEI M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/26/2006
Last Update Date: 11/04/2020
Certification Date: 11/04/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

684 SIXES RD STE 265
HOLLY SPRINGS GA
30115-8720
US

IV. Provider business mailing address

6600 PEACHTREE DUNWOODY RD STE 325
ATLANTA GA
30328-6773
US

V. Phone/Fax

Practice location:
  • Phone: 770-720-2221
  • Fax: 770-720-2282
Mailing address:
  • Phone: 48-922-1314
  • Fax: 404-215-9222

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License Number85319
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: