Provider Demographics
NPI:1821041740
Name:SKAF, MICHEL W (MD)
Entity Type:Individual
Prefix:
First Name:MICHEL
Middle Name:W
Last Name:SKAF
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:428S DURBIN ST 104
Mailing Address - Street 2:
Mailing Address - City:CASPER
Mailing Address - State:WY
Mailing Address - Zip Code:82601-2818
Mailing Address - Country:US
Mailing Address - Phone:307-337-4283
Mailing Address - Fax:
Practice Address - Street 1:428S DURBIN ST 104
Practice Address - Street 2:
Practice Address - City:CASPER
Practice Address - State:WY
Practice Address - Zip Code:82601-2818
Practice Address - Country:US
Practice Address - Phone:307-337-4284
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-19
Last Update Date:2015-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY7159A207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
WY20373OtherBCBS
WYP00351461OtherRAILROAD MEDICARE
WY121557400Medicaid
WY313774OtherBLUE SHIELD
WYI34526Medicare UPIN
WYW20373Medicare UPIN
WYP00351461OtherRAILROAD MEDICARE