Provider Demographics
NPI:1255340600
Name:SKURCENSKI, CRAIG A (MD)
Entity type:Individual
Prefix:DR
First Name:CRAIG
Middle Name:A
Last Name:SKURCENSKI
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 1:409 S 2ND ST
Mailing Address - Street 2:SUITE 2F
Mailing Address - City:HARRISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17104-1612
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:111 S FRONT ST
Practice Address - Street 2:
Practice Address - City:HARRISBURG
Practice Address - State:PA
Practice Address - Zip Code:17101
Practice Address - Country:US
Practice Address - Phone:717-988-0000
Practice Address - Fax:717-782-5716
Is Sole Proprietor?:No
Enumeration Date:2006-08-05
Last Update Date:2020-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD068579L207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA001759501Medicaid
PA029742Medicare PIN
PA001371962OtherHIGHMARK BS
OHH00877Medicare UPIN
OH2455150Medicaid
PA1514799OtherGATEWAY
PA029742RQJMedicare PIN
PA112039OtherUNISON
PA930078349OtherRAIL ROAD MEDICARE
OHSK4126852Medicare ID - Type Unspecified
PA029742GXTMedicare PIN
PA1831750OtherFIRST HEALTH
PA0017595010003Medicaid