Individual
TRAVIS SHELTON ANSLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
1099
SC
207L00000X
Anesthesiology Physician
2009-01131
NC
207L00000X
Anesthesiology Physician
TMP 001009
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010990
—
SC
05
—
1942424122
—
NC
01
—
P00680393
RAILROAD-MEDICARE
NC
01
—
P00680393
RAILROAD-MEDICARE
SC
Enumeration date
04/12/2007
Last updated
09/18/2024
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