Provider Demographics
NPI:1629066998
Name:SKROBOT, DAVID MICHAEL (DPM)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:MICHAEL
Last Name:SKROBOT
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5042 BATESON BEACH DR NE
Mailing Address - Street 2:
Mailing Address - City:THORNVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43076-9663
Mailing Address - Country:US
Mailing Address - Phone:740-704-7517
Mailing Address - Fax:740-242-4146
Practice Address - Street 1:5042 BATESON BEACH DR NE
Practice Address - Street 2:
Practice Address - City:THORNVILLE
Practice Address - State:OH
Practice Address - Zip Code:43076-9663
Practice Address - Country:US
Practice Address - Phone:740-705-7517
Practice Address - Fax:740-242-4146
Is Sole Proprietor?:No
Enumeration Date:2005-10-11
Last Update Date:2020-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH36002748213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0880748Medicaid
OH0720334Medicare PIN
OH0720337Medicare PIN
OH0520050001Medicare NSC
OH0880748Medicaid