Basic Information
Provider Information
NPI: 1114147931
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SKOWRONSKI
FirstName: PIOTR
MiddleName: PAWEL
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 3726
Address2:  
City: AUGUSTA
State: GA
PostalCode: 309143726
CountryCode: US
TelephoneNumber: 7068639595
FaxNumber: 7068688375
Practice Location
Address1: 3675 J DEWEY GRAY CIR STE 300
Address2:  
City: AUGUSTA
State: GA
PostalCode: 309091868
CountryCode: US
TelephoneNumber: 7068639595
FaxNumber: 7068688375
Other Information
ProviderEnumerationDate: 04/26/2007
LastUpdateDate: 06/03/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 06/03/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
2086S0122XME107545FLN Allopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive Surgery
2086S0122XDR.0061914CON Allopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive Surgery
2086S0122X26792MSN Allopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive Surgery
2086S0122X065617GAY Allopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive Surgery

No ID Information.


Home