Healthcare Provider Details

I. General information

NPI: 1366241614
Provider Name (Legal Business Name): DANIEL SKOLODA PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/10/2025
Last Update Date: 03/10/2025
Certification Date: 03/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 NORTH WOLFE STREET CARNEGIE BLDG ROOM 180
BALTIMORE MD
21287
US

IV. Provider business mailing address

9719 TALL OAKS RD
MONTGOMERY VILLAGE MD
20886-3161
US

V. Phone/Fax

Practice location:
  • Phone: 330-720-3890
  • Fax:
Mailing address:
  • Phone: 330-720-3890
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835X0200X
TaxonomyOncology Pharmacist
License Number28116
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: