Individual
JOHN CHARLES GERANCHER III
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3331 HEALY DR, #26851, WINSTON SALEM, NC 27103-1407
(336) 408-1036
Mailing address
PO BOX 26851, WINSTON SALEM, NC 27114-6851
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
9500077
NC
207LP2900X
Pain Medicine (Anesthesiology) Physician
9500077
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12707
PARTNERS
—
05
—
1802064000
—
WV
01
—
3510H
BCBS OF NC
—
01
—
5152060
AETNA
—
05
—
5708150
—
VA
05
—
893510H
—
NC
01
—
89600
MEDCOST
—
05
—
Q0007B
—
SC
Enumeration date
12/13/2005
Last updated
11/14/2023
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