Traver, Michael Fahey

Traver, Michael Fahey is an individual health care provider with primary practice located at 1000 Mar Walt Drive Ptu, Fort Walton Beach FL 32547. He recently has only one registered license in Allopathic & Osteopathic Physicians / Psychiatry, which is considered as his primary health care specialty. Traver, Michael Fahey can be contacted via phone (850) 862-1111.

Contact Information

Primary practice address
1000 Mar Walt Drive Ptu Fort Walton Beach FL 32547
Phone: (850) 862-1111
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Psychiatry 2084P0800X MD15180 Hawaii
Allopathic & Osteopathic Physicians / Psychiatry 2084P0800X ME122840 Florida

Profile Details

NPI number 1275739021
LBN Legal business name Traver, Michael Fahey
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 26th, 2007
Last updated Jan 7th, 2019 - about 6 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1275739021 NPPES
Florida MEDICAID 015007900

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