Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Y00000X | Otolaryngologist (ENT Doctor) | 21802 | SC |
N | 207Y00000X | Otolaryngologist (ENT Doctor) | MD423272 | PA |
Y | 207YS0123X | Facial Plastic Surgeon | 21802 | SC |
N | 207YX0007X | Plastic Surgeon (Head & Neck) | 21802 | SC |
NPI | 1316935489 |
---|---|
Provider Name | Judith M Skoner |
First Address | Charlotte, NC 28275-1461 |
Second Address | Charleston, SC 29425-0001 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/10/2005 |
Last Update Date | 13/06/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1008484860001 | (05) | PA |
218026 | (05) | SC |
H64489 | (02) |