Provider Demographics
NPI:1740463702
Name:TRAVER, MICHAEL ARTHURE (MD)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:ARTHURE
Last Name:TRAVER
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:577 MICHIGAN AVE
Mailing Address - Street 2:SUITE 201
Mailing Address - City:HOLLAND
Mailing Address - State:MI
Mailing Address - Zip Code:49423-4911
Mailing Address - Country:US
Mailing Address - Phone:616-392-1816
Mailing Address - Fax:616-392-1292
Practice Address - Street 1:577 MICHIGAN AVE
Practice Address - Street 2:SUITE 201
Practice Address - City:HOLLAND
Practice Address - State:MI
Practice Address - Zip Code:49423-4911
Practice Address - Country:US
Practice Address - Phone:616-392-1816
Practice Address - Fax:616-392-1292
Is Sole Proprietor?:No
Enumeration Date:2007-12-13
Last Update Date:2015-07-29
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Provider Licenses
StateLicense IDTaxonomies
MIMT094255208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
1952507444OtherGROUP NPI
MI0P49290Medicare PIN
MIB31161Medicare UPIN