MITCHELL E F TRAVIS (NPI# 1336174598) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1336174598 |
Entity Type | Individual |
Full Name | MITCHELL E F TRAVIS |
Credential | MD |
Practice Address |
10517 Maple Springs Cv Fort Wayne IN 46845-2132 |
Mailing Address |
11995 Singletree Ln Ste 500 Eden Prairie MN 55344-5347 |
Practice Telephone | 9525951100 |
Practice Fax Number | 6122944903 |
Mailing Telephone | 9525951301 |
Mailing Fax Number | 6122944903 |
Enumeration Date | 2006-07-12 |
Last Update Date | 2015-12-08 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
MD60447306 | WA | Allopathic & Osteopathic Physicians |
N | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
1876 | MN | Allopathic & Osteopathic Physicians |
N | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
51163 | TN | Allopathic & Osteopathic Physicians |
Y | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
01043985 | IN | Allopathic & Osteopathic Physicians |
Street Address |
10517 MAPLE SPRINGS CV |
City | FORT WAYNE |
State | IN |
Zip Code | 46845-2132 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1881154110 | Nancy Jean Ehmke | Clinical Nurse Specialist | 11151 Parkview Plaza Dr, Fort Wayne, IN 46845 | 2019-03-22 |
1043703903 | Kara Stackhouse | Nurse Practitioner | 11050 Parkview Plaza Drive, Fort Wayne, IN 46845 | 2018-06-14 |
1871082412 | Tara K Jellison | Pharmacist | 11109 Parkview Plaza Drive -- Attn Pharmacy, Fort Wayne, IN 46845 | 2018-05-09 |
1578097572 | Forefront Dermatology, S.c. | Dermatology | 4020 New Vision Drive, Fort Wayne, IN 46845 | 2017-04-17 |
1811437999 | Jessica Ann Lefever | Behavioral Analyst | 3898 New Vision Dr Ste D, Fort Wayne, IN 46845 | 2017-03-08 |
1033668041 | Bhi Home Care, Inc. | In Home Supportive Care | 820 Mill Lake Road, Fort Wayne, IN 46845 | 2016-10-03 |
1467814939 | Austin Wyss | Specialist/Technologist | 11130 Parkview Circle Drive, Ft. Wayne, IN 46845 | 2016-03-24 |
1154713584 | Ashley Whitcraft | Specialist/Technologist | 11130 Parkview Plaza Drive #4, Fort Wayne, IN 46845 | 2015-02-23 |
1275975682 | Lakshmi Mohan Viji Das | Internal Medicine | 11143 Parkview Plaza Dr Ste 311, Fort Wayne, IN 46845 | 2013-07-26 |
1336482496 | Mithun Mohana Shenoi | Colon & Rectal Surgery | 11104 Parkview Circle Drive Suite 320, Fort Wayne, IN 46845 | 2013-03-27 |
Find all providers in zip 46845 |
Taxonomy Code | 2085R0202X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Radiology |
Specialization | Diagnostic Radiology |
A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Radiology, 2007. http://www.theabr.org/. American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Radiology. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1376789420 | Richard Frederick Fox | Radiology | 6226 Devils Hollow Rd., Fort Wayne, IN 46814 | 2008-12-19 |
1578607149 | Garland Richard Brown | Radiology | 1007 Three Rivers N, Fort Wayne, IN 46802-1334 | 2007-02-16 |
1932205077 | Kavita K Erickson | Radiology | 5001 Us Highway 30 W, Suite D, Fort Wayne, IN 46818-9701 | 2006-09-16 |
1033226154 | Alan S. Cooperman | Radiology | 14110 Spring Hollow Rd, Fort Wayne, IN 46814-9767 | 2006-08-24 |
1023062130 | Gregg R Mattison | Radiology | 3707 New Vision Drive, Fort Wayne, IN 46895-5602 | 2006-05-22 |
1184678278 | Charles Tsai | Radiology | 109 Chestnut Hills Pkwy, Fort Wayne, IN 46814-8924 | 2006-05-22 |
1922061613 | Mri Center - Fort Wayne Radiology Inc | Radiology | 2110 Carew St, Fort Wayne, IN 46805-4712 | 2006-04-11 |
1861455669 | Open View Mri, LLC | Radiology | 10202 Coldwater Rd, Fort Wayne, IN 46825-2076 | 2006-04-11 |
1902870033 | Jay T Jones | Radiology | 3707 New Vision Dr, Fort Wayne, IN 46845-1702 | 2006-02-15 |
1871564336 | Imaging Diagnostic Center Limited | Radiology | 7900 W Jefferson Blvd Ste 101, Fort Wayne, IN 46804-4128 | 2006-01-31 |
Find all providers in FORT WAYNE |
City | FORT WAYNE |
Zip Code | 46845 |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.