Individual
DR. PAUL ALBERT SKUDDER JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
100 CAMP ST, HYANNIS, MA 02601
(508) 775-1984
(508) 790-1987
Mailing address
100 CAMP ST, HYANNIS, MA 02601-3063
(508) 775-1984
(508) 790-1987
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
55871
MA
2086S0102X
Surgical Critical Care Physician
55871
MA
2086S0129X
Vascular Surgery Physician
Primary
55871
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01144650
—
NY
Enumeration date
10/14/2005
Last updated
07/26/2021
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