MITCHELL E F TRAVIS

FORT WAYNE, IN
NPI1336174598
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy2085R0202X Radiology, Diagnostic Radiology
(Licence: IN  01043985)
Additional Taxonomies2085R0202X Radiology, Diagnostic Radiology
(Licence: WA  MD60447306)
2085R0202X Radiology, Diagnostic Radiology
(Licence: MN  1876)
2085R0202X Radiology, Diagnostic Radiology
(Licence: TN  51163)
Enumeration Date2006-07-12
Last Update Date2021-03-05
Business Address
MITCHELL E F TRAVIS MD
10517 MAPLE SPRINGS CV
FORT WAYNE, IN 46845-2132
Phone number: 952-595-1100
Mailing Address
MITCHELL E F TRAVIS MD
3707 NEW VISION DR
FORT WAYNE, IN 46845-1702
Phone number: 260-373-4731