Provider Demographics
NPI:1396776324
Name:MONCHAMP, TRAVIS LOUIS (MD)
Entity type:Individual
Prefix:
First Name:TRAVIS
Middle Name:LOUIS
Last Name:MONCHAMP
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 670
Mailing Address - Street 2:
Mailing Address - City:BEND
Mailing Address - State:OR
Mailing Address - Zip Code:97709-0670
Mailing Address - Country:US
Mailing Address - Phone:541-317-5600
Mailing Address - Fax:541-317-5676
Practice Address - Street 1:929 SW SIMPSON AVE
Practice Address - Street 2:SUITE 220
Practice Address - City:BEND
Practice Address - State:OR
Practice Address - Zip Code:97702-3599
Practice Address - Country:US
Practice Address - Phone:541-317-5600
Practice Address - Fax:541-317-5676
Is Sole Proprietor?:No
Enumeration Date:2006-07-06
Last Update Date:2020-02-18
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
ORMD26567207UN0902X, 207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
No207UN0902XAllopathic & Osteopathic PhysiciansNuclear MedicineNuclear Imaging & Therapy