Provider Demographics
NPI:1447393798
Name:SLUDER, RAINA ARNOLD (MD)
Entity Type:Individual
Prefix:DR
First Name:RAINA
Middle Name:ARNOLD
Last Name:SLUDER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:377 COLD SPRINGS RD
Mailing Address - Street 2:
Mailing Address - City:MOUNTAIN CITY
Mailing Address - State:TN
Mailing Address - Zip Code:37683-4023
Mailing Address - Country:US
Mailing Address - Phone:423-727-7243
Mailing Address - Fax:
Practice Address - Street 1:377 COLD SPRINGS RD
Practice Address - Street 2:
Practice Address - City:MOUNTAIN CITY
Practice Address - State:TN
Practice Address - Zip Code:37683-4023
Practice Address - Country:US
Practice Address - Phone:423-727-7243
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-15
Last Update Date:2023-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN35582207P00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1447393798Medicaid
VA1447393798Medicaid
TN103I086050Medicare PIN
TNH44585Medicare UPIN