Healthcare Provider Details

I. General information

NPI: 1568459824
Provider Name (Legal Business Name): MARTIN C SKIE M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/03/2005
Last Update Date: 12/28/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3000 ARLINGTON AVE ORTHOPEDIC SURGERY
TOLEDO OH
43614-2595
US

IV. Provider business mailing address

3355 GLENDALE AVE FL 3
TOLEDO OH
43614-2426
US

V. Phone/Fax

Practice location:
  • Phone: 419-383-3761
  • Fax: 419-383-6255
Mailing address:
  • Phone: 419-383-3761
  • Fax: 419-383-6255

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number35063109
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code207XS0106X
TaxonomyOrthopaedic Hand Surgery Physician
License Number35063109
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: