MEDICARE: THEODORE SHELDON PARINS M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208600000X	Surgery Physician	36040	WI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1437168473
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	THEODORE SHELDON PARINS M.D.

Provider Business Mailing Address
First Line	:	250 26TH ST
Second Line	:
City	:	PRAIRIE DU SAC
State	:	WI
Zip	:	53578-2204
Country	:	US
Telephone Number	:	608-643-2431
Fax Number	:	608-643-0048

Provider Business Practice Location Address
First Line	:	250 26TH ST STE 315
Second Line	:
City	:	PRAIRIE DU SAC
State	:	WI
Zip	:	53578-2204
Country	:	US
Telephone Number	:	608-643-2431
Fax Number	:	608-643-0048

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/07/2006
Last Update Date	:	03/24/2021

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