Individual
MICHELLE MARIE SKINNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
2401 BRANDERMILL BLVD, GAMBRILLS, MD 21054-1690
(410) 721-1507
(410) 721-1510
Mailing address
PO BOX 12622, BELFAST, ME 04915-4017
(443) 481-6576
(443) 481-6515
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
2747
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3810026534
—
WV
Enumeration date
06/21/2010
Last updated
09/15/2015
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