Provider Demographics
NPI:1245210210
Name:SKAR, DUANE C (MD)
Entity Type:Individual
Prefix:DR
First Name:DUANE
Middle Name:C
Last Name:SKAR
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 1:1804 7TH ST W
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55116-2300
Mailing Address - Country:US
Mailing Address - Phone:651-227-7806
Mailing Address - Fax:651-256-6766
Practice Address - Street 1:1804 7TH ST W
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55116-2300
Practice Address - Country:US
Practice Address - Phone:651-227-7806
Practice Address - Fax:651-256-6766
Is Sole Proprietor?:No
Enumeration Date:2006-01-18
Last Update Date:2016-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN30836208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN1245210210Medicaid
F28480Medicare UPIN