MEDICARE: DAVID V SKIRBALL 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
1	207RP1001X	Pulmonary Disease Physician	35040867	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	A79977	OTHER	OH	UPIN

General Provider Information

NPI Number	:	1932101474
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAVID V SKIRBALL M.D.

Provider Business Mailing Address
First Line	:	PO BOX 567
Second Line	:
City	:	CHAGRIN FALLS
State	:	OH
Zip	:	44022-0567
Country	:	US
Telephone Number	:	216-464-5160
Fax Number	:	216-464-5982

Provider Business Practice Location Address
First Line	:	3461 WARRENSVILLE CENTER RD
Second Line	:
City	:	SHAKER HTS
State	:	OH
Zip	:	44122-5260
Country	:	US
Telephone Number	:	216-991-9128
Fax Number	:	216-752-5248

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/15/2005
Last Update Date	:	10/12/2007

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