Healthcare Provider Details

I. General information

NPI: 1306834296
Provider Name (Legal Business Name): JOHN E SCHRECENGOST MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/13/2005
Last Update Date: 06/05/2026
Certification Date: 06/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 SINGLETON RIDGE RD
CONWAY SC
29526-9142
US

IV. Provider business mailing address

PO BOX 1599
CONWAY SC
29528-1599
US

V. Phone/Fax

Practice location:
  • Phone: 843-347-7144
  • Fax: 843-347-7331
Mailing address:
  • Phone: 843-347-7144
  • Fax: 843-347-7331

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207ZP0102X
TaxonomyAnatomic Pathology & Clinical Pathology Physician
License Number95754
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: