Individual
TRAVIS WADE CASPER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2235 CLEVELAND RD, SOUTH BEND, IN 46628-3529
(574) 647-4530
(574) 647-2285
Mailing address
3245 HEALTH DRIVE, SUITE 100, GRANGER, IN 46530-3245
(574) 647-1840
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01068197A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200982160
—
IN
Enumeration date
07/05/2007
Last updated
04/28/2023
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