Provider Demographics
NPI:1043447790
Name:OLIVES, TRAVIS D (MD)
Entity Type:Individual
Prefix:DR
First Name:TRAVIS
Middle Name:D
Last Name:OLIVES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:701 PARK AVE SOUTH - MEDICINE
Mailing Address - Street 2:HENNEPIN COUNTY MEDICAL CENTER
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55415-1829
Mailing Address - Country:US
Mailing Address - Phone:612-873-2300
Mailing Address - Fax:
Practice Address - Street 1:701 PARK AVE SOUTH - MEDICINE
Practice Address - Street 2:HENNEPIN COUNTY MEDICAL CENTER
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55415-1829
Practice Address - Country:US
Practice Address - Phone:612-873-2300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-06-19
Last Update Date:2014-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN57283207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine