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Individual

DR. THOMAS G. TRAUTMANN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1057 RED VENTURES DR STE 150, FORT MILL, SC 29707-2518
(803) 548-3708
(803) 431-2249
Mailing address
1420 E 7TH ST STE 400, CHARLOTTE, NC 28204-2408
(704) 375-0100
(704) 375-8623

Taxonomy

Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
21301
SC
2085R0001X
Radiation Oncology Physician
Primary
30104
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1170F
BLUE CROSS
NC
01
1818082007
CIGNA
NC
01
2086657
UNITED HEALTHCARE
NC
01
6225
PARTNERS
NC
01
84865
MEDCOST
NC
05
8983701
NC
05
N30104
SC
Enumeration date
03/20/2006
Last updated
12/27/2017
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