Provider Demographics
NPI:1740316538
Name:SKAFF, MATTHEW D (DC)
Entity type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:D
Last Name:SKAFF
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13057 W CENTER RD
Mailing Address - Street 2:SUITE #7
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68144-3748
Mailing Address - Country:US
Mailing Address - Phone:402-330-2510
Mailing Address - Fax:
Practice Address - Street 1:13057 W CENTER RD
Practice Address - Street 2:SUITE #7
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68144-3748
Practice Address - Country:US
Practice Address - Phone:402-330-2510
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1070111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE9768OtherBLUE CROSS
NE47082985400Medicaid
NE47082985400Medicaid