Provider Demographics
NPI:1558314369
Name:SKINNER, ELIZABETH NAISANG (MD)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:NAISANG
Last Name:SKINNER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 75216
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28275-0216
Mailing Address - Country:US
Mailing Address - Phone:336-718-7080
Mailing Address - Fax:336-718-9622
Practice Address - Street 1:3333 SILAS CREEK PKWY
Practice Address - Street 2:
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27103-3013
Practice Address - Country:US
Practice Address - Phone:336-277-8800
Practice Address - Fax:336-277-8850
Is Sole Proprietor?:No
Enumeration Date:2006-05-19
Last Update Date:2022-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC200300886207VX0201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VX0201XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologic Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1558314369Medicaid
NC189421OtherMEDCOST
NC5903761Medicaid
NC13411OtherBLUE CROSS BLUE SHIELD
NC2365784OtherUNITED HEALTHCARE
7296451OtherAETNA US HEALTHCARE
P00270693OtherRAILROAD MEDICARE
NC803406OtherPARTNERS NATIONAL HEALTH
1783167OtherCIGNA HEALTHCARE
VA010268982Medicaid
NC2019417AMedicare PIN
NC2019417BMedicare PIN
NC13411OtherBLUE CROSS BLUE SHIELD