Healthcare Provider Details

I. General information

NPI: 1194778985
Provider Name (Legal Business Name): YASHBIR S RANA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/19/2006
Last Update Date: 09/29/2022
Certification Date: 09/29/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

261 PENICK DR
DUNCAN SC
29334-8717
US

IV. Provider business mailing address

261 PENICK DR
DUNCAN SC
29334-8717
US

V. Phone/Fax

Practice location:
  • Phone: 864-384-3332
  • Fax:
Mailing address:
  • Phone: 864-384-3332
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number15940
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: