MEDICARE: DR. THOMAS G. TRAUTMANN 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	2085R0001X	Radiation Oncology Physician	21301	SC
2	2085R0001X	Radiation Oncology Physician	30104	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	84865	OTHER	NC	MEDCOST
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	1170F	OTHER	NC	BLUE CROSS
4	2086657	OTHER	NC	UNITED HEALTHCARE
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6	6225	OTHER	NC	PARTNERS
7	1818082007	OTHER	NC	CIGNA

General Provider Information

NPI Number	:	1437118338
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. THOMAS G. TRAUTMANN M.D.

Provider Business Mailing Address
First Line	:	1420 E 7TH ST STE 400
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28204-2408
Country	:	US
Telephone Number	:	704-375-0100
Fax Number	:	704-375-8623

Provider Business Practice Location Address
First Line	:	1057 RED VENTURES DR STE 150
Second Line	:
City	:	FORT MILL
State	:	SC
Zip	:	29707-2518
Country	:	US
Telephone Number	:	803-548-3708
Fax Number	:	803-431-2249

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

Provider Enumeration Date	:	03/20/2006
Last Update Date	:	12/27/2017

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