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NPI 1750477741

NPI 1750477741 : RICHARD MARK SKAROFF M.D. : PHILADELPHIA, PA

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General NPI Number Information
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    NPI Number           |    1750477741
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    Entity Type          |    Individual 
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    Provider Name        |    RICHARD MARK SKAROFF M.D.
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    10/05/2006
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    Last Update Date     |    07/08/2007
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Provider Practice Location Address
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    Address Line         |    8001 ROOSEVELT BLVD. SUITE 209
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    City                 |    PHILADELPHIA
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    State                |    PA
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    Zip                  |    19152-3038
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    Country              |    US
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    Telephone            |    215-543-9300
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    Fax                  |    215-543-9313
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Provider Business Mailing Address
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    Address Line         |    8001 ROOSEVELT BLVD. SUITE 209
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    City                 |    PHILADELPHIA
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    State                |    PA
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    Zip                  |    19152-3038
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    Country              |    US
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    Telephone            |    215-543-9300
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    Fax                  |    215-543-9313
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    207Q00000X
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    Taxonomy Name        |    Family Medicine Physician
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    License Number       |    MD027118E
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    License Number State |    PA
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