Healthcare Provider Details

I. General information

NPI: 1508203522
Provider Name (Legal Business Name): DANIEL CARL SKIPPER DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/31/2013
Last Update Date: 04/20/2026
Certification Date: 04/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7900 N KINGS HWY
MYRTLE BEACH SC
29572-3055
US

IV. Provider business mailing address

7900 N KINGS HWY
MYRTLE BEACH SC
29572-3055
US

V. Phone/Fax

Practice location:
  • Phone: 843-449-3381
  • Fax: 843-449-9721
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207ZP0102X
TaxonomyAnatomic Pathology & Clinical Pathology Physician
License NumberMDO.1684 LL
License Number StateSC
# 2
Primary TaxonomyY
Taxonomy Code207ZP0102X
TaxonomyAnatomic Pathology & Clinical Pathology Physician
License NumberDO1684
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: