Provider Demographics
NPI:1295935971
Name:LOVE, TRAVIS C (DO)
Entity type:Individual
Prefix:DR
First Name:TRAVIS
Middle Name:C
Last Name:LOVE
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:950 HOUSTON NORTHCUTT BLVD STE 205
Mailing Address - Street 2:
Mailing Address - City:MOUNT PLEASANT
Mailing Address - State:SC
Mailing Address - Zip Code:29464-5645
Mailing Address - Country:US
Mailing Address - Phone:843-818-3800
Mailing Address - Fax:843-894-3308
Practice Address - Street 1:950 HOUSTON NORTHCUTT BLVD STE 205
Practice Address - Street 2:
Practice Address - City:MOUNT PLEASANT
Practice Address - State:SC
Practice Address - Zip Code:29464-5645
Practice Address - Country:US
Practice Address - Phone:843-818-3800
Practice Address - Fax:888-491-9486
Is Sole Proprietor?:No
Enumeration Date:2007-07-20
Last Update Date:2024-09-16
Deactivation Date:2018-06-18
Deactivation Code:
Reactivation Date:2018-07-13
Provider Licenses
StateLicense IDTaxonomies
SCDO51703207NS0135X, 207RS0010X, 2083P0901X, 207RB0002X, 207RE0101X, 207RG0300X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207NS0135XAllopathic & Osteopathic PhysiciansDermatologyProcedural Dermatology
No207RS0010XAllopathic & Osteopathic PhysiciansInternal MedicineSports Medicine
No2083P0901XAllopathic & Osteopathic PhysiciansPreventive MedicinePublic Health & General Preventive Medicine
No207RB0002XAllopathic & Osteopathic PhysiciansInternal MedicineObesity Medicine
No207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
No207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine