Provider Demographics
NPI:1568406411
Name:TRABUE, CHRISTOPHER H (MD)
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:H
Last Name:TRABUE
Suffix:
Gender:M
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:PO BOX 501123
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63150-0001
Mailing Address - Country:US
Mailing Address - Phone:615-284-8740
Mailing Address - Fax:
Practice Address - Street 1:316 22ND AVE N
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37203-1842
Practice Address - Country:US
Practice Address - Phone:615-284-5185
Practice Address - Fax:615-284-3147
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-15
Last Update Date:2019-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN38122207RI0200X, 207R00000X, 208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN4181401OtherBLUE CROSS BLUE SHIELD OF TN
TN1505214Medicaid
TN9997154OtherAETNA
TN33307002Medicare PIN
TN9997154OtherAETNA
TNI30992Medicare UPIN