Provider Demographics
NPI:1265491807
Name:SKALIOTIS, ANARGYROS T (PA-C)
Entity Type:Individual
Prefix:
First Name:ANARGYROS
Middle Name:T
Last Name:SKALIOTIS
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 MILL RD
Mailing Address - Street 2:SUITE 180
Mailing Address - City:FAIRHAVEN
Mailing Address - State:MA
Mailing Address - Zip Code:02719-5252
Mailing Address - Country:US
Mailing Address - Phone:508-973-2000
Mailing Address - Fax:508-973-2001
Practice Address - Street 1:370 FAUNCE CORNER RD
Practice Address - Street 2:
Practice Address - City:NORTH DARTMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02747-1271
Practice Address - Country:US
Practice Address - Phone:508-973-9050
Practice Address - Fax:508-999-5151
Is Sole Proprietor?:No
Enumeration Date:2006-03-22
Last Update Date:2020-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAAP2077363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI31289OtherBCBS-RHODE ISLAND
RI413277OtherBLUE CHIP-RI
MAP00314068OtherRAILROAD MEDICARE
RI31289OtherBCBS-RHODE ISLAND
RI413277OtherBLUE CHIP-RI