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DR. TED CLONTZ M.D. NPI 1639141666


NPI Information

NPI: 1639141666
Provider Name: DR. TED CLONTZ, M.D.
Classification: Family Medicine - 207Q00000X
Entity Type: Individual
Address:
8401 MEDICAL PLAZA DR
STE 365
CHARLOTTE, NC
ZIP 28262
Phone: (704) 944-0975
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DR. Ted Clontz, M.D. is a family medicine in Charlotte, NC. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. DR. Ted Clontz, M.D. NPI is 1639141666. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

8401 MEDICAL PLAZA DR
STE 365
CHARLOTTE, NC
ZIP 28262-797
Phone: (704) 944-0975
Fax: (704) 944-3699

The enumeration date for this NPI number is 2/3/2006 and was last updated on 3/10/2015.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207Q00000XFamily Medicine1981-25563NORTH CAROLINANo
2207Q00000XFamily Medicine25563NORTH CAROLINAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1N25563MEDICAIDSOUTH CAROLINA
2C83273MEDICARE UPINNORTH CAROLINA
3205480JMEDICARE ID-TYPE UNSPECIFIEDNORTH CAROLINA
4891232HMEDICAIDNORTH CAROLINA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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