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Individual

DR. MARK A. SKIRGAUDAS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
11811 NE 128TH STREET, KIRKLAND, WA 98034-7200
(425) 821-3472
(425) 820-4115
Mailing address
PO BOX 94624, SEATTLE, WA 98124-6924
(800) 634-4064
(952) 513-6880

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
041299
CT
2085R0202X
Diagnostic Radiology Physician
Primary
MD60082335
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
001412999
CT
01
010041299CT01
ANTHEM BC/BS
CT
01
A2516306
OXFORD
CT
Enumeration date
12/20/2005
Last updated
12/08/2011
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