Individual
MARYANN TRAXLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
100 BILLINGSLEY RD, CHARLOTTE, NC 28211-1002
(704) 376-7447
(704) 376-2172
Mailing address
521 CLANTON RD, CHARLOTTE, NC 28217
(704) 332-9001
(704) 295-1755
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
9700784
NC
2084A0401X
Addiction Medicine (Psychiatry & Neurology) Physician
9700784
NC
2084P0800X
Psychiatry Physician
Primary
9700784
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
02973
BCBS GROUP
—
01
—
1094Y
BCBS
—
01
—
2136229
AETNA
NC
Enumeration date
08/16/2005
Last updated
11/30/2023
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