Healthcare Provider Details

I. General information

NPI: 1710239983
Provider Name (Legal Business Name): EMILY JEANNE SKOVIRA DVM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/11/2012
Last Update Date: 10/11/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5918 W BROAD ST
RICHMOND VA
23230-2231
US

IV. Provider business mailing address

5918 W BROAD ST
RICHMOND VA
23230-2231
US

V. Phone/Fax

Practice location:
  • Phone: 804-716-4700
  • Fax: 804-716-4705
Mailing address:
  • Phone: 804-716-4700
  • Fax: 804-716-4705

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174M00000X
TaxonomyVeterinarian
License Number0301203327
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: