Individual
DR. MICHAEL FAHEY TRAVER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1000 MAR WALT DRIVE, PTU, FORT WALTON BEACH, FL 32547
(850) 862-1111
Mailing address
718 DUFFER LN, ANTHONY, NM 88021-9318
(808) 721-6497
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
MD15180
HI
2084P0800X
Psychiatry Physician
Primary
ME122840
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
015007900
—
FL
Enumeration date
06/26/2007
Last updated
01/07/2019
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