Most Relevant Information
Provider Data
| NPI Number: | 1003311705 |
| Provider Name: | TRAVIS DANIEL BONTRAGER MD |
| Entity Type: | Individual |
| Taxonomy Code: | 390200000X |
| Specialty: | Student in an Organized Health Care Education/Training Program |
| License Number: |
Most Important Dates
| Enumeration Date: | 03/26/2018 |
| Last Updated: | 06/25/2024 |
Provider Practice Location
20 YORK ST
NEW HAVEN
CT
065103220
Practice Location Phone/Fax
| Phone: | 2036881734 |
| Fax: | 4752469106 |
Provider Mailing Location
20 YORK ST
NEW HAVEN
CT
065103220
Provider Mailing Phone/Fax
| Phone: | 2036881734 |
| Fax: | 4752469106 |