Individual
MICHAEL W SKEHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2600 FERRY ST, LAFAYETTE, IN 47904-3055
(765) 448-8000
(765) 448-8666
Mailing address
PO BOX 5545, LAFAYETTE, IN 47903-5545
(765) 448-8000
(765) 448-8085
Taxonomy
Speciality
Code
Description
License number
State
207RR0500X
Rheumatology Physician
Primary
01030034A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000176497
ANTHEM PROVIDER NUMBER
IN
05
—
100231510
—
IN
01
—
10825961
CAQH NUMBER
IN
01
—
9397477
PHCS PID NUMBER
IN
05
—
SK80528011
—
IN
Enumeration date
03/20/2006
Last updated
12/09/2008
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