Provider Demographics
NPI:1306014550
Name:SKVARKA, CHRISTOPHER BRIAN (MD)
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:BRIAN
Last Name:SKVARKA
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 1:3001 NEWCASTLE LOOP
Mailing Address - Street 2:ATTN: LISA BASS
Mailing Address - City:MYRTLE BEACH
Mailing Address - State:SC
Mailing Address - Zip Code:29588-4502
Mailing Address - Country:US
Mailing Address - Phone:843-215-1100
Mailing Address - Fax:843-215-1211
Practice Address - Street 1:3001 NEWCASTLE LOOP
Practice Address - Street 2:ATTN: LISA BASS
Practice Address - City:MYRTLE BEACH
Practice Address - State:SC
Practice Address - Zip Code:29588-4502
Practice Address - Country:US
Practice Address - Phone:843-215-1100
Practice Address - Fax:843-215-1211
Is Sole Proprietor?:No
Enumeration Date:2008-02-11
Last Update Date:2012-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC30688207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC306886Medicaid
SCAA26666Medicare UPIN
SC306886Medicaid