Provider Demographics
NPI:1023017233
Name:SKAHILL, STEVEN EARL (MD)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:EARL
Last Name:SKAHILL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:239 GREEN ST
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSTON
Mailing Address - State:NC
Mailing Address - Zip Code:27892-2000
Mailing Address - Country:US
Mailing Address - Phone:252-792-0022
Mailing Address - Fax:252-792-0027
Practice Address - Street 1:239 GREEN ST
Practice Address - Street 2:
Practice Address - City:WILLIAMSTON
Practice Address - State:NC
Practice Address - Zip Code:27892-2000
Practice Address - Country:US
Practice Address - Phone:252-792-0022
Practice Address - Fax:252-792-0027
Is Sole Proprietor?:No
Enumeration Date:2005-07-19
Last Update Date:2019-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC200200174207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC89132V0Medicaid
NC2000864AMedicare ID - Type UnspecifiedMEDICARE
NC89132V0Medicaid