Basic Information
| Provider Information | |||||||||
| NPI: | 1801870258 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SCHRANK | ||||||||
| FirstName: | MARK | ||||||||
| MiddleName: | L | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5 NEPONSET ST FL STREET12 | ||||||||
| Address2: | |||||||||
| City: | WORCESTER | ||||||||
| State: | MA | ||||||||
| PostalCode: | 016062714 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5085952300 | ||||||||
| FaxNumber: | 5088535226 | ||||||||
| Practice Location | |||||||||
| Address1: | 5 NEPONSET ST | ||||||||
| Address2: | |||||||||
| City: | WORCESTER | ||||||||
| State: | MA | ||||||||
| PostalCode: | 016062714 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5085952300 | ||||||||
| FaxNumber: | 5088535226 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/30/2005 | ||||||||
| LastUpdateDate: | 09/14/2018 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 54140 | MA | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
ID Information
| ID | Type | State | Issuer | Description | 042472266 | 01 | HEALTHCARE VALUE MNGMENT | OTHER | 27015 | 01 | CHILDRENS MED SECURITY PL | OTHER | AA1247 | 01 | HARVARD PILGRIM HEALTHCAR | OTHER | J04376 | 01 | BLUE SHIELD HMO BLUE | OTHER | 110170358 | 01 | RAILROAD MEDICARE | OTHER | 6389589 | 01 | CIGNA HEALTH PLAN | OTHER | 0401699 | 01 | EVERCARE | OTHER | 3099911 | 01 | MEDICAID/WELFARE | OTHER | 9900099 | 01 | FALLON COMMUNITY HLTH PL | OTHER | 042472266 | 01 | PRIVATE HEALTHCARE SYSTEM | OTHER | J04376 | 01 | BLUE CARE ELECT | OTHER | 7017326 | 01 | AETNA/US HEALTHCARE | OTHER | J04376 | 01 | BLUE SHIELD INDEMNITY | OTHER | 27015 | 01 | HEALTHY START | OTHER | 784187 | 01 | MVP HEALTH CARE | OTHER | 925677 | 01 | FIRST HEALTH | OTHER | J04376 | 01 | MEDICARE B | OTHER | 042472266 | 01 | ONE HEALTH PLAN | OTHER |