Healthcare Provider Details

I. General information

NPI: 1477577328
Provider Name (Legal Business Name): DAVID G. SKOWRONEK MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/26/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

608 W ACADEMY ST
RANDLEMAN NC
27317-9748
US

IV. Provider business mailing address

550 WHITE OAK ST
ASHEBORO NC
27203-4710
US

V. Phone/Fax

Practice location:
  • Phone: 336-495-1001
  • Fax: 336-495-1005
Mailing address:
  • Phone: 336-625-1360
  • Fax: 336-625-1889

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code173000000X
TaxonomyLegal Medicine
License NumberAS8189234
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: