Provider Demographics
NPI:1851336655
Name:SKINNER, GAYLE V (MD)
Entity Type:Individual
Prefix:
First Name:GAYLE
Middle Name:V
Last Name:SKINNER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:8110 MAPLE LAWN BLVD STE 235
Mailing Address - Street 2:
Mailing Address - City:FULTON
Mailing Address - State:MD
Mailing Address - Zip Code:20759-2693
Mailing Address - Country:US
Mailing Address - Phone:301-340-8339
Mailing Address - Fax:301-340-9027
Practice Address - Street 1:10801 LOCKWOOD DR STE 320
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20901-1559
Practice Address - Country:US
Practice Address - Phone:301-681-3400
Practice Address - Fax:301-681-7982
Is Sole Proprietor?:No
Enumeration Date:2006-06-17
Last Update Date:2023-12-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MDD0063554207V00000X, 207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD408882400Medicaid
DC175228ZAK4Medicare PIN
I50060Medicare UPIN
MD408882400Medicaid
MDG02263E01Medicare ID - Type UnspecifiedINDIVIDUAL PROVIDER #
MD405954900Medicaid