Individual
DR. STEVE M SKOUMAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1950 E CLARK ST, SUITE D, POCATELLO, ID 83201-3314
(208) 233-3794
(208) 233-3795
Mailing address
PO BOX 2537, POCATELLO, ID 83206-2537
(208) 233-3794
(208) 233-3795
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
M-7677
ID
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
M7677
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
002467700
—
ID
01
—
820334553
TAX ID
—
Enumeration date
01/12/2007
Last updated
09/07/2010
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