Individual
DR. ROLAND L SKINNER III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
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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