Provider Demographics
NPI:1043779150
Name:SKIPINA, TRAVIS MILAN (MD (2019))
Entity Type:Individual
Prefix:
First Name:TRAVIS
Middle Name:MILAN
Last Name:SKIPINA
Suffix:
Gender:M
Credentials:MD (2019)
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2402 AVENHAM AVE SW APT 3
Mailing Address - Street 2:
Mailing Address - City:ROANOKE
Mailing Address - State:VA
Mailing Address - Zip Code:24014-1622
Mailing Address - Country:US
Mailing Address - Phone:920-858-2416
Mailing Address - Fax:
Practice Address - Street 1:500 MARTHA JEFFERSON DR
Practice Address - Street 2:
Practice Address - City:CHARLOTTESVILLE
Practice Address - State:VA
Practice Address - Zip Code:22911-4668
Practice Address - Country:US
Practice Address - Phone:434-654-7580
Practice Address - Fax:434-654-7582
Is Sole Proprietor?:No
Enumeration Date:2019-03-18
Last Update Date:2023-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC390200000X
VA0101278890208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program