Provider Demographics
NPI:1194777821
Name:SCHRANK, JOHN HENRY JR (MD)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:HENRY
Last Name:SCHRANK
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 105
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29602-0105
Mailing Address - Country:US
Mailing Address - Phone:864-250-0607
Mailing Address - Fax:864-250-0608
Practice Address - Street 1:811 PENDLETON STREET
Practice Address - Street 2:SUITES 10 & 11
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29601
Practice Address - Country:US
Practice Address - Phone:864-250-0607
Practice Address - Fax:864-250-0608
Is Sole Proprietor?:No
Enumeration Date:2006-05-17
Last Update Date:2024-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC19354207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC193542Medicaid
SC110240818OtherRR MEDICARE
SCP00817200OtherRR MEDICARE
SCG61700Medicare UPIN
SC193542Medicaid
SCG617007951Medicare PIN