Provider Demographics
NPI:1811974348
Name:PARRAN, THEODORE V (MD)
Entity type:Individual
Prefix:
First Name:THEODORE
Middle Name:V
Last Name:PARRAN
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2351 E 22ND ST
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44115-3111
Mailing Address - Country:US
Mailing Address - Phone:216-363-2580
Mailing Address - Fax:216-363-2575
Practice Address - Street 1:2351 E 22ND ST
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44115-3111
Practice Address - Country:US
Practice Address - Phone:216-363-2580
Practice Address - Fax:216-363-2575
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-27
Last Update Date:2025-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.0569162084A0401X
OH35056916207RA0401X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RA0401XAllopathic & Osteopathic PhysiciansInternal MedicineAddiction Medicine
No2084A0401XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyAddiction Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH000000135960OtherANTHEM
OH0704116Medicaid
OH110142214OtherPALMETTO GBA RETIRED
OH0678451Medicare ID - Type Unspecified