Individual
MACKENZIE SKELLAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
301 SAINT PAUL PL, POB 912, BALTIMORE, MD 21202-2102
(410) 332-9653
Mailing address
301 SAINT PAUL PL, MEDICAL STAFF OFFICE, BALTIMORE, MD 21202-2102
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
C0005172
MD
Other
Enumeration date
09/05/2013
Last updated
09/05/2013
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