Provider Demographics
NPI:1336270651
Name:TREFNY, FRANK A (MD)
Entity Type:Individual
Prefix:
First Name:FRANK
Middle Name:A
Last Name:TREFNY
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:PO BOX 119
Mailing Address - Street 2:
Mailing Address - City:KINGSTREE
Mailing Address - State:SC
Mailing Address - Zip Code:29556-0119
Mailing Address - Country:US
Mailing Address - Phone:843-354-5426
Mailing Address - Fax:843-354-7115
Practice Address - Street 1:500 THURGOOD MARSHALL BLVD
Practice Address - Street 2:SUITE H
Practice Address - City:KINGSTREE
Practice Address - State:SC
Practice Address - Zip Code:29556-4143
Practice Address - Country:US
Practice Address - Phone:843-354-5426
Practice Address - Fax:843-354-7115
Is Sole Proprietor?:No
Enumeration Date:2007-03-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC7009208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC070096Medicaid
B91571Medicare UPIN