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Individual

DR. TRAVIS WYATT MCCOY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
17 CALEDON CT, SUITE C, GREENVILLE, SC 29615-3170
(864) 232-7734
(864) 232-7099
Mailing address
17 CALEDON CT, SUITE C, GREENVILLE, SC 29615-3170
(864) 232-7734
(864) 232-7099

Taxonomy

Speciality
Code
Description
License number
State
207VE0102X
Reproductive Endocrinology Physician
Primary
37787
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0000000522575
ANTHEM
KY
01
000000522532
ANTHEM
KY
05
200866890
IN
01
50015433
PASSPORT PCP
KY
01
50015434
PASSPORT SPECIALITY
KY
01
50015435
PASSPORT SPECIALITY
KY
05
7100012890
KY
Enumeration date
01/22/2007
Last updated
02/09/2015
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