Provider Demographics
NPI:1477527638
Name:SKAHEN, JAMES RAYMOND III (MD)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:RAYMOND
Last Name:SKAHEN
Suffix:III
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 1:4601 PARK RD
Mailing Address - Street 2:SUITE 300
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28209-3239
Mailing Address - Country:US
Mailing Address - Phone:704-323-2000
Mailing Address - Fax:
Practice Address - Street 1:354 COPPERFIELD BLVD
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:NC
Practice Address - Zip Code:28025
Practice Address - Country:US
Practice Address - Phone:704-323-2000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-02-15
Last Update Date:2011-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC9600738207X00000X, 207XS0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0106XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryHand Surgery
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
5941184OtherAETNA
200036905OtherRAILROAD MEDICARE
530008OtherPRINCIPAL HEALTHCARE
77138OtherBCBS OF NC
0382260001OtherDMERC MEDICARE SUPPLY
0941273OtherUNITED HEALTHCARE
NC8977138Medicaid
SCQ38096Medicaid
65692OtherMEDCOST
3969941002OtherCIGNA HEALTHCARE
2069466OtherAETNA US HEALTHCARE
27122OtherPARTNERS MEDICARE
0941273OtherUNITED HEALTHCARE
65692OtherMEDCOST
5941184OtherAETNA