Provider Demographics
NPI:1295702991
Name:TESTERMAN, MARY CHRIS (MD)
Entity type:Individual
Prefix:DR
First Name:MARY
Middle Name:CHRIS
Last Name:TESTERMAN
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 1:9184 HEMINGWAY GROVE CIR
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37922-8090
Mailing Address - Country:US
Mailing Address - Phone:865-661-9384
Mailing Address - Fax:
Practice Address - Street 1:9184 HEMINGWAY GROVE CIR
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37922-8090
Practice Address - Country:US
Practice Address - Phone:865-661-9384
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-03-02
Last Update Date:2024-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN29290207XX0004X
TNMD29290207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
No207XX0004XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryFoot and Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN200030630OtherRAILROAD MEDICARE
TNTN0156OtherJOHN DEERE HEALTHCARE
TN1201443OtherUNITED HEALTH CARE
TN3087106OtherBLUE CROSS BLUE SHIELD
TN4457891OtherAETNA
TN100010640OtherTENNCARE
TN3818769Medicaid
TNTN0160OtherJOHN DEERE HEALTHCARE
TN1201443OtherUNITED HEALTH CARE
TN200030630OtherRAILROAD MEDICARE
TN100010640OtherTENNCARE
TN103I202083Medicare PIN