Individual
KEITH MITCHELL SKUBITZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
424 HARVARD STREET SE, MASONIC CANCER CENTER, FIRST FLOOR, SUITE M100, MINNEAPOLIS, MN 55455
(612) 625-5411
Mailing address
420 DELAWARE STREET SE, UNIVERSITY OF MINNESOTA PHYSICIANS, MINNEAPOLIS, MN 55455
(612) 625-5411
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
23896
MN
207RX0202X
Medical Oncology Physician
Primary
23896
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
100796
UCARE
MN
01
—
1009310
PREFERRED ONE
MN
05
—
10387
—
ND
01
—
2T180SK
BLUE CROSS BLUE SHIELD
MN
05
—
30713600
—
WI
01
—
36-00013
MEDICA PRIMARY
MN
01
—
36-00276
MEDICA CHOICE
MN
01
—
597099
ARAZ
MN
05
—
757873300
—
MN
05
—
7777470
—
SD
01
—
HP22239
HEALTH PARTNERS
MN
Enumeration date
10/19/2006
Last updated
10/29/2012
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