Provider Demographics
NPI:1972552750
Name:SKLADANIEC, DARIUSZ ADAM (MD)
Entity type:Individual
Prefix:DR
First Name:DARIUSZ
Middle Name:ADAM
Last Name:SKLADANIEC
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:307 UNIVERSITY BLVD N
Mailing Address - Street 2:HSB SUITE 1200
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36688-0002
Mailing Address - Country:US
Mailing Address - Phone:251-460-7681
Mailing Address - Fax:251-414-8227
Practice Address - Street 1:307 UNIVERSITY BLVD N
Practice Address - Street 2:HSB SUITE 1200
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36688-0002
Practice Address - Country:US
Practice Address - Phone:251-460-7681
Practice Address - Fax:251-414-8227
Is Sole Proprietor?:No
Enumeration Date:2006-05-09
Last Update Date:2008-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL27574207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL630477348036OtherTRICARE CHAMPUS
AL51537385OtherBCBS-STUDENT HLTH
AL51537385OtherBCBS-STUDENT HLTH