Provider Demographics
NPI:1922083831
Name:SKOW, BRIAN STEVEN (MD)
Entity Type:Individual
Prefix:
First Name:BRIAN
Middle Name:STEVEN
Last Name:SKOW
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 1:6401 E FAWN CIR
Mailing Address - Street 2:
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57110-1303
Mailing Address - Country:US
Mailing Address - Phone:605-275-0736
Mailing Address - Fax:
Practice Address - Street 1:800 E 21ST ST
Practice Address - Street 2:
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57105-1016
Practice Address - Country:US
Practice Address - Phone:605-322-2000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-12-13
Last Update Date:2008-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD5171207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN580622400Medicaid
IA0567610Medicaid
SD6004630Medicaid
NE46022474331Medicaid
SD9219546OtherDAKOTACARE
SD0041326OtherSD BLUECROSS
MN118K2SKOtherMN BLUE CROSS BS
SD6004630Medicaid
SDP00033779Medicare PIN