Provider Demographics
NPI:1487740544
Name:SKLAR, DAVID AARON
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:AARON
Last Name:SKLAR
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14731 MANHATTAN PL
Mailing Address - Street 2:
Mailing Address - City:OAK PARK
Mailing Address - State:MI
Mailing Address - Zip Code:48237-1017
Mailing Address - Country:US
Mailing Address - Phone:248-968-3412
Mailing Address - Fax:
Practice Address - Street 1:14731 MANHATTAN PL
Practice Address - Street 2:7035 ORCHARD LAKE ROAD SUITE 550
Practice Address - City:OAK PARK
Practice Address - State:MI
Practice Address - Zip Code:48237-1017
Practice Address - Country:US
Practice Address - Phone:248-808-0283
Practice Address - Fax:248-808-0283
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-05
Last Update Date:2009-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010207791041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIM56380052Medicare ID - Type Unspecified