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General NPI Number Information
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NPI Number | 1972273274
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Entity Type | Individual
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Provider Name | TRAVIS GEORGE HUNYARA PA-C
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Gender | Male
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Dates
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Enumeration Date | 09/17/2021
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Last Update Date | 09/17/2021
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Provider Practice Location Address
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Address Line | 755 NORMAN DR
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City | LEBANON
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State | PA
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Zip | 17042-3704
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Country | US
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Telephone | 717-273-6706
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Fax |
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Provider Business Mailing Address
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Address Line | 233 MOONHILL DR
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City | SCHUYLKILL HAVEN
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State | PA
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Zip | 17972-9360
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Country | US
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Telephone | 570-640-5173
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | MA062952
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License Number State | PA
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