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Individual

DR. ROLAND L SKINNER III

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
800 E CHEVES ST, SUITE 380, FLORENCE, SC 29506-2650
(843) 665-4104
Mailing address
PO BOX 3239, FLORENCE, SC 29502-3239
(843) 665-4104

Taxonomy

Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
10392
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
039
TRICARE
SC
01
068
BLUE CHOICE
SC
01
069
BCBS
SC
05
103925
SC
01
224300
MEDCOST
SC
01
4002967
CIGNA
SC
01
5120202(PIN)
AETNA
SC
01
D055848552
MEDICARE PTAN
SC
Enumeration date
11/29/2006
Last updated
03/02/2010
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