Provider Demographics
NPI:1306808860
Name:POLK, TRAVIS MARTIN (MD)
Entity type:Individual
Prefix:DR
First Name:TRAVIS
Middle Name:MARTIN
Last Name:POLK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3032 JACOBS GARDEN LN
Mailing Address - Street 2:
Mailing Address - City:FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:21701-3384
Mailing Address - Country:US
Mailing Address - Phone:757-375-1659
Mailing Address - Fax:
Practice Address - Street 1:8901 ROCKVILLE PIKE
Practice Address - Street 2:
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20889-2111
Practice Address - Country:US
Practice Address - Phone:301-295-4440
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-04-03
Last Update Date:2025-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD4384252086S0102X
PA4384252086S0127X
VA0101233378208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
No2086S0102XAllopathic & Osteopathic PhysiciansSurgerySurgical Critical Care
No2086S0127XAllopathic & Osteopathic PhysiciansSurgeryTrauma Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAPAROtherUSA MANAGED CARE
VAPAROtherVIRGINIA HEALTH NETWORK
VA10122737OtherOPTIMA HEALTH
VA1306808860OtherUNITED HEALTHCARE
VA1306808860OtherVIRGINIA PREMIER HEALTH PLAN
VA1306808860Medicaid
VAPAROtherAETNA
VAPAROtherMULTIPLAN
VA505895OtherANTHEM BC/BS
VA1306808860OtherCOVENTRY NETWORK
VAPAROtherCIGNA
NC1306808860Medicaid
VAPAROtherCORVEL
VA505895OtherANTHEM BC/BS
NC1306808860Medicaid