Healthcare Provider Details

I. General information

NPI: 1811974348
Provider Name (Legal Business Name): THEODORE V PARRAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/27/2005
Last Update Date: 04/17/2025
Certification Date: 04/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2351 E 22ND ST
CLEVELAND OH
44115-3111
US

IV. Provider business mailing address

2351 E 22ND ST
CLEVELAND OH
44115-3111
US

V. Phone/Fax

Practice location:
  • Phone: 216-363-2580
  • Fax: 216-363-2575
Mailing address:
  • Phone: 216-363-2580
  • Fax: 216-363-2575

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084A0401X
TaxonomyAddiction Medicine (Psychiatry & Neurology) Physician
License Number35.056916
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code207RA0401X
TaxonomyAddiction Medicine (Internal Medicine) Physician
License Number35056916
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: