Provider Demographics
NPI:1720311715
Name:STEPHANIE SKOW MD INC
Entity type:Organization
Organization Name:STEPHANIE SKOW MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:L
Authorized Official - Last Name:SKOW
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:808-352-2013
Mailing Address - Street 1:4334 RICE ST
Mailing Address - Street 2:203 A
Mailing Address - City:LIHUE
Mailing Address - State:HI
Mailing Address - Zip Code:96766-1810
Mailing Address - Country:US
Mailing Address - Phone:808-634-2376
Mailing Address - Fax:808-245-6495
Practice Address - Street 1:4334 RICE ST
Practice Address - Street 2:203 A
Practice Address - City:LIHUE
Practice Address - State:HI
Practice Address - Zip Code:96766-1810
Practice Address - Country:US
Practice Address - Phone:808-634-2376
Practice Address - Fax:808-245-6495
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-09
Last Update Date:2009-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI149402084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty