Provider Demographics
NPI:1760655153
Name:DAVID SCIBEK
Entity Type:Organization
Organization Name:DAVID SCIBEK
Other - Org Name:CROWFIELD FAMILY FOOTCARE
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:J
Authorized Official - Last Name:SCIBEK
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:843-863-8860
Mailing Address - Street 1:114 SPRINGHALL DR
Mailing Address - Street 2:
Mailing Address - City:GOOSE CREEK
Mailing Address - State:SC
Mailing Address - Zip Code:29445-5335
Mailing Address - Country:US
Mailing Address - Phone:843-863-8860
Mailing Address - Fax:843-863-8837
Practice Address - Street 1:114 SPRINGHALL DR
Practice Address - Street 2:
Practice Address - City:GOOSE CREEK
Practice Address - State:SC
Practice Address - Zip Code:29445-5335
Practice Address - Country:US
Practice Address - Phone:843-863-8860
Practice Address - Fax:843-863-8837
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-08
Last Update Date:2008-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC514213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC5823340001Medicare NSC