Provider Demographics
NPI:1861470205
Name:SCHELL, SCOTT THOMAS (MD)
Entity Type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:THOMAS
Last Name:SCHELL
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 1163
Mailing Address - Street 2:
Mailing Address - City:SOUTHERN PINES
Mailing Address - State:NC
Mailing Address - Zip Code:28388-1163
Mailing Address - Country:US
Mailing Address - Phone:910-692-4759
Mailing Address - Fax:910-433-4475
Practice Address - Street 1:2545 RAVENHILL DR
Practice Address - Street 2:STE. 105
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
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-05
Last Update Date:2012-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC290352084P0800X
CAC305872084P0800X
OH35-03-0167-S2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC7974855Medicaid
NC74855OtherBCBS
NCC86326Medicare UPIN
NC210201BMedicare ID - Type Unspecified