Provider Demographics
NPI:1720069867
Name:TRAYNELIS, CHRISTIAN LOUIS (MD)
Entity Type:Individual
Prefix:DR
First Name:CHRISTIAN
Middle Name:LOUIS
Last Name:TRAYNELIS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:744 MIDDLE CREEK ROAD
Mailing Address - Street 2:SUITE 208
Mailing Address - City:SEVIERVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37862
Mailing Address - Country:US
Mailing Address - Phone:865-446-9675
Mailing Address - Fax:865-446-9701
Practice Address - Street 1:744 MIDDLE CREEK ROAD
Practice Address - Street 2:SUITE 208
Practice Address - City:SEVIERVILLE
Practice Address - State:TN
Practice Address - Zip Code:37862
Practice Address - Country:US
Practice Address - Phone:865-446-9675
Practice Address - Fax:865-446-9701
Is Sole Proprietor?:No
Enumeration Date:2005-11-07
Last Update Date:2020-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD34366208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3874815Medicaid
TNG28913Medicare UPIN