Provider Demographics
NPI:1588841597
Name:TRAYWICK, CARMEN ANDERSON (MD)
Entity Type:Individual
Prefix:
First Name:CARMEN
Middle Name:ANDERSON
Last Name:TRAYWICK
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:PO BOX 2330
Mailing Address - Street 2:
Mailing Address - City:BLUFFTON
Mailing Address - State:SC
Mailing Address - Zip Code:29910-2330
Mailing Address - Country:US
Mailing Address - Phone:843-837-4400
Mailing Address - Fax:
Practice Address - Street 1:350 FORDING ISLAND ROAD
Practice Address - Street 2:SUITE 100
Practice Address - City:BLUFFTON
Practice Address - State:SC
Practice Address - Zip Code:29910
Practice Address - Country:US
Practice Address - Phone:843-837-4400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-01-22
Last Update Date:2021-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA62788207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC31457OtherSC STATE MEDICAL LICENSE