Provider Demographics
NPI:1508120825
Name:DR SCOTT T SCHELL MD PA
Entity Type:Organization
Organization Name:DR SCOTT T SCHELL MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:GLENN
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:910-433-4446
Mailing Address - Street 1:175 W NEW HAMPSHIRE AVE
Mailing Address - Street 2:
Mailing Address - City:SOUTHERN PINES
Mailing Address - State:NC
Mailing Address - Zip Code:28387-4826
Mailing Address - Country:US
Mailing Address - Phone:910-692-4759
Mailing Address - Fax:910-433-4475
Practice Address - Street 1:2545 RAVENHILL DR STE 105
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28303-5460
Practice Address - Country:US
Practice Address - Phone:910-433-4446
Practice Address - Fax:910-433-4475
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-07-02
Last Update Date:2013-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC29035251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC74855OtherBCBS
NC7974588Medicaid
NC7974588Medicaid
NC74855OtherBCBS