Healthcare Provider Details
I. General information
NPI: 1972439602
Provider Name (Legal Business Name): STEVEN SKOVRAN PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 06/22/2026
Last Update Date: 06/22/2026
Certification Date: 06/21/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
4420 LAKE BOONE TRL
RALEIGH NC
27607-7505
US
IV. Provider business mailing address
113 WILBUR LAKE DR
FUQUAY VARINA NC
27526-3228
US
V. Phone/Fax
- Phone: 919-784-3100
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 1835E0208X |
| Taxonomy | Emergency Medicine Pharmacist |
| License Number | 28683 |
| License Number State | NC |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: