Provider Demographics
NPI:1194718627
Name:SKOLOFF, JOSEPH STEPHEN (MD)
Entity type:Individual
Prefix:MR
First Name:JOSEPH
Middle Name:STEPHEN
Last Name:SKOLOFF
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21785 FILIGREE COURT
Mailing Address - Street 2:SUITE 100
Mailing Address - City:ASHBURN
Mailing Address - State:VA
Mailing Address - Zip Code:20147-6214
Mailing Address - Country:US
Mailing Address - Phone:703-554-1100
Mailing Address - Fax:703-554-1110
Practice Address - Street 1:21785 FILIGREE COURT
Practice Address - Street 2:SUITE 100
Practice Address - City:ASHBURN
Practice Address - State:VA
Practice Address - Zip Code:20147-6214
Practice Address - Country:US
Practice Address - Phone:703-554-1100
Practice Address - Fax:703-554-1110
Is Sole Proprietor?:No
Enumeration Date:2005-08-30
Last Update Date:2011-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101027893208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1194718627Medicaid
VA370001128Medicare ID - Type Unspecified
VA1194718627Medicaid