Provider Demographics
NPI:1720393853
Name:P.MICHAEL SKALIY, MD, PC
Entity Type:Organization
Organization Name:P.MICHAEL SKALIY, MD, PC
Other - Org Name:PARADIGM ANESTHESIA ASSOCIATES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:ANA
Authorized Official - Middle Name:
Authorized Official - Last Name:PULIDO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:770-236-8884
Mailing Address - Street 1:PO BOX 420709
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30342-0709
Mailing Address - Country:US
Mailing Address - Phone:770-236-8884
Mailing Address - Fax:678-325-2919
Practice Address - Street 1:12425 MORRIS RD
Practice Address - Street 2:
Practice Address - City:ALPHARETTA
Practice Address - State:GA
Practice Address - Zip Code:30005-4137
Practice Address - Country:US
Practice Address - Phone:770-236-8884
Practice Address - Fax:678-325-2919
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-12
Last Update Date:2021-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain MedicineGroup - Multi-Specialty