Provider Demographics
NPI:1427244821
Name:W MATTHEW SKEWES MD PC
Entity type:Organization
Organization Name:W MATTHEW SKEWES MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:W
Authorized Official - Middle Name:MATTHEW
Authorized Official - Last Name:SKEWES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:540-674-0770
Mailing Address - Street 1:112 BROAD ST
Mailing Address - Street 2:
Mailing Address - City:DUBLIN
Mailing Address - State:VA
Mailing Address - Zip Code:24084
Mailing Address - Country:US
Mailing Address - Phone:540-674-0770
Mailing Address - Fax:540-674-2872
Practice Address - Street 1:112 BROAD ST
Practice Address - Street 2:
Practice Address - City:DUBLIN
Practice Address - State:VA
Practice Address - Zip Code:24084
Practice Address - Country:US
Practice Address - Phone:540-674-0770
Practice Address - Fax:540-674-2872
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-19
Last Update Date:2011-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101041733207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAC08382Medicare PIN