Healthcare Provider Details

I. General information

NPI: 1144277765
Provider Name (Legal Business Name): CLARENCE SCRANAGE JR. M.D
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/28/2006
Last Update Date: 01/18/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

713 N COURTHOUSE RD SUITE 200
NORTH CHESTERFIELD VA
23236-4074
US

IV. Provider business mailing address

PO BOX 38959
HENRICO VA
23231-1311
US

V. Phone/Fax

Practice location:
  • Phone: 804-858-3040
  • Fax: 888-849-0589
Mailing address:
  • Phone: 804-840-6575
  • Fax: 866-855-3111

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code146D00000X
TaxonomyPersonal Emergency Response Attendant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: