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Individual
DR. TRAVIS CLYDE
Active
Individual
DR. TRAVIS CLYDE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
M-14185
ID
207Q00000X
Family Medicine Physician
M-14185
ID
207Q00000X
Family Medicine Physician
MRM-1547
ID
207QS0010X
Sports Medicine (Family Medicine) Physician
Primary
M-14185
ID
Other
Enumeration date
06/13/2016
Last updated
04/15/2024
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