Provider Demographics
NPI:1659346344
Name:SCHANK, DENNIS J (MD)
Entity Type:Individual
Prefix:
First Name:DENNIS
Middle Name:J
Last Name:SCHANK
Suffix:
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 1:1601 MEDICAL DR
Mailing Address - Street 2:
Mailing Address - City:POTTSTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19464-3241
Mailing Address - Country:US
Mailing Address - Phone:610-327-4200
Mailing Address - Fax:610-327-8160
Practice Address - Street 1:23 N WALNUT ST
Practice Address - Street 2:
Practice Address - City:BOYERTOWN
Practice Address - State:PA
Practice Address - Zip Code:19512-1467
Practice Address - Country:US
Practice Address - Phone:610-367-2259
Practice Address - Fax:610-367-0505
Is Sole Proprietor?:No
Enumeration Date:2006-02-17
Last Update Date:2019-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD039529E207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
B95927Medicare UPIN
80030829Medicare PIN
007585Medicare ID - Type Unspecified