MEDICARE: DR. RICHARD THOMAS TRAVIS MD

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	207XX0005X	Sports Medicine (Orthopaedic Surgery) Physician	D0046550	MD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	D0046550	OTHER	MD	MEDICAL LICENSE NUMBER

General Provider Information

NPI Number	:	1952812208
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RICHARD THOMAS TRAVIS MD

Provider Business Mailing Address
First Line	:	3113 CATRINA LN
Second Line	:
City	:	ANNAPOLIS
State	:	MD
Zip	:	21403-4340
Country	:	US
Telephone Number	:	410-280-2057
Fax Number	:

Provider Business Practice Location Address
First Line	:	3113 CATRINA LN
Second Line	:
City	:	ANNAPOLIS
State	:	MD
Zip	:	21403-4340
Country	:	US
Telephone Number	:	410-280-2057
Fax Number	:

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

Provider Enumeration Date	:	10/13/2017
Last Update Date	:	04/12/2026

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