MEDICARE: SUSAN F TRAVIS M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208000000X	Pediatrics Physician	MD014051E	PA
2	208000000X	Pediatrics Physician	25MA03289400	NJ
3	2080P0207X	Pediatric Hematology & Oncology Physician	MD014051E	PA
4	2080P0207X	Pediatric Hematology & Oncology Physician	25MA03289400	NJ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1437168200
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SUSAN F TRAVIS M.D.

Provider Business Mailing Address
First Line	:	100 N 20TH ST
Second Line	:	CHCA SUITE 301
City	:	PHILADELPHIA
State	:	PA
Zip	:	19103-1443
Country	:	US
Telephone Number	:	215-567-2422
Fax Number	:	215-561-0959

Provider Business Practice Location Address
First Line	:	1012 LAUREL OAK RD
Second Line	:	SPECIALTY CENTER AT VOORHEES
City	:	VOORHEES
State	:	NJ
Zip	:	08043-3505
Country	:	US
Telephone Number	:	856-435-7502
Fax Number	:	215-561-0959

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/07/2006
Last Update Date	:	09/11/2025

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