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NPI Code Detail

MEDICARE: DR. MARK E SKILLAN M.D.

MEDICARE:  DR. MARK E SKILLAN  M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207R00000XInternal Medicine Physician024094GA

General Provider Information

NPI Number : 1679738447
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MARK E SKILLAN M.D.
Provider Business Mailing Address
First Line : 102 WAKEFIELD DR NE
Second Line :
City : ATLANTA
State : GA
Zip : 30309-1517
Country : US
Telephone Number : 404-367-9985
Fax Number :
Provider Business Practice Location Address
First Line : 102 WAKEFIELD DR NE
Second Line :
City : ATLANTA
State : GA
Zip : 30309-1517
Country : US
Telephone Number : 404-367-9985
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/22/2008
Last Update Date : 07/22/2008

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Directions to “ DR. MARK E SKILLAN M.D.” Practice Location

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