Provider Demographics
NPI:1629334867
Name:SKODA-MOUNT, EMILY CATHERINE (MD)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:CATHERINE
Last Name:SKODA-MOUNT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:EMILY
Other - Middle Name:CATHERINE
Other - Last Name:SKODA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:9811 MALLARD DR
Mailing Address - Street 2:SUITE # 109
Mailing Address - City:LAUREL
Mailing Address - State:MD
Mailing Address - Zip Code:20708-3143
Mailing Address - Country:US
Mailing Address - Phone:301-776-8000
Mailing Address - Fax:301-776-6753
Practice Address - Street 1:9811 MALLARD DR
Practice Address - Street 2:SUITE # 109
Practice Address - City:LAUREL
Practice Address - State:MD
Practice Address - Zip Code:20708-3143
Practice Address - Country:US
Practice Address - Phone:301-776-8000
Practice Address - Fax:301-776-6753
Is Sole Proprietor?:No
Enumeration Date:2012-04-02
Last Update Date:2015-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0080101208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics