Individual
TRAVIS SHELTON ANSLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
118 PROFESSIONAL PARK DR, ROCK HILL, SC 29732-1178
(803) 329-3124
Mailing address
927 EAST BLVD, CHARLOTTE, NC 28203-5203
(704) 377-5772
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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