Provider Demographics
NPI:1144277765
Name:SCRANAGE, CLARENCE JR (MD)
Entity type:Individual
Prefix:DR
First Name:CLARENCE
Middle Name:
Last Name:SCRANAGE
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 38959
Mailing Address - Street 2:
Mailing Address - City:HENRICO
Mailing Address - State:VA
Mailing Address - Zip Code:23231-1311
Mailing Address - Country:US
Mailing Address - Phone:804-840-6575
Mailing Address - Fax:866-855-3111
Practice Address - Street 1:713 N COURTHOUSE RD
Practice Address - Street 2:SUITE 200
Practice Address - City:NORTH CHESTERFIELD
Practice Address - State:VA
Practice Address - Zip Code:23236-4074
Practice Address - Country:US
Practice Address - Phone:804-858-3040
Practice Address - Fax:888-849-0589
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-28
Last Update Date:2016-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes146D00000XEmergency Medical Service ProvidersPersonal Emergency Response Attendant
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA194829OtherANTHEM BLUE CROSS
VA6065554Medicaid
VAB06233Medicare UPIN