Provider Demographics
NPI:1811099104
Name:SKOPIC, AMER (DO)
Entity type:Individual
Prefix:
First Name:AMER
Middle Name:
Last Name:SKOPIC
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:515 MIDDLE TPKE W STE 120
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER
Mailing Address - State:CT
Mailing Address - Zip Code:06040-3816
Mailing Address - Country:US
Mailing Address - Phone:860-533-0008
Mailing Address - Fax:
Practice Address - Street 1:18 HAYNES ST STE A
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:CT
Practice Address - Zip Code:06040-4111
Practice Address - Country:US
Practice Address - Phone:860-522-1171
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-05
Last Update Date:2023-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT052786207RG0100X, 207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CTD400147281Medicare PIN