Provider Demographics
NPI:1942409057
Name:PARCEL, TED WILLIAM
Entity Type:Individual
Prefix:
First Name:TED
Middle Name:WILLIAM
Last Name:PARCEL
Suffix:
Gender:M
Credentials:
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 60447
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28260-0447
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6 DOCTORS CIR STE 5
Practice Address - Street 2:
Practice Address - City:SUPPLY
Practice Address - State:NC
Practice Address - Zip Code:28462-6358
Practice Address - Country:US
Practice Address - Phone:910-721-4370
Practice Address - Fax:920-721-4379
Is Sole Proprietor?:No
Enumeration Date:2007-07-18
Last Update Date:2024-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2010-00774207X00000X, 207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL000816700Medicaid
FL9635281OtherAETNA
NC1942409057Medicaid
FL21009OtherBCBS
FL329931OtherAVMED
SCNC1303Medicaid
FLP00779274OtherMEDICARE RAILROAD
NC5916648Medicaid
FL000816700Medicaid
NC2403303Medicare PIN