MEDICARE: TODD ANDREW TRAVERS

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	376J00000X	Homemaker		OH

General Provider Information

NPI Number	:	1700755097
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TODD ANDREW TRAVERS

Provider Business Mailing Address
First Line	:	905 HAMPTON DR
Second Line	:
City	:	MACEDONIA
State	:	OH
Zip	:	44056-1923
Country	:	US
Telephone Number	:	330-631-2162
Fax Number	:	330-631-2162

Provider Business Practice Location Address
First Line	:	905 HAMPTON DR
Second Line	:
City	:	MACEDONIA
State	:	OH
Zip	:	44056-1923
Country	:	US
Telephone Number	:	330-631-2162
Fax Number	:	330-631-2162

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

Provider Enumeration Date	:	11/04/2025
Last Update Date	:	11/04/2025

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