Provider Demographics
NPI:1407876196
Name:SKOLNICK, ERIC D (MD)
Entity Type:Individual
Prefix:
First Name:ERIC
Middle Name:D
Last Name:SKOLNICK
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 1:11913 WHISTLER CT
Mailing Address - Street 2:
Mailing Address - City:POTOMAC
Mailing Address - State:MD
Mailing Address - Zip Code:20854-3350
Mailing Address - Country:US
Mailing Address - Phone:301-762-1999
Mailing Address - Fax:
Practice Address - Street 1:110 IRVING ST NW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20010-2976
Practice Address - Country:US
Practice Address - Phone:202-877-7500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-19
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCMD31580207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC0102OtherCAREFIRST BCBS
DC7117146OtherAETNA NON HMO
VA441060OtherANTHEM BCBS
DC202424OtherKAISER
VA5719470Medicaid
DC2494589OtherAETNA HMO
DC501353OtherNCPPO
VA5719470Medicaid
G99399Medicare UPIN