Healthcare Provider Details

I. General information

NPI: 1275739021
Provider Name (Legal Business Name): MICHAEL FAHEY TRAVER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/26/2007
Last Update Date: 08/03/2026
Certification Date: 08/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

70 COMMERCIAL ST STE 200
CONCORD NH
03301-5094
US

IV. Provider business mailing address

403 MAPLE ST
HOPKINTON NH
03229-3357
US

V. Phone/Fax

Practice location:
  • Phone: 603-617-4799
  • Fax: 603-883-0007
Mailing address:
  • Phone: 808-721-6497
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number39892
License Number StateNH
# 2
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberMD15180
License Number StateHI
# 3
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberME122840
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: