Provider Demographics
NPI:1063508539
Name:TAYLOR, WILLIAM CLIFFORD (MD)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:CLIFFORD
Last Name:TAYLOR
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 1:106 MILFORD ST STE 201
Mailing Address - Street 2:
Mailing Address - City:SALISBURY
Mailing Address - State:MD
Mailing Address - Zip Code:21804-6959
Mailing Address - Country:US
Mailing Address - Phone:410-543-1616
Mailing Address - Fax:410-543-8497
Practice Address - Street 1:106 MILFORD ST. STE 201
Practice Address - Street 2:
Practice Address - City:SALISBURY
Practice Address - State:MD
Practice Address - Zip Code:21804
Practice Address - Country:US
Practice Address - Phone:410-543-1952
Practice Address - Fax:410-543-8497
Is Sole Proprietor?:No
Enumeration Date:2006-10-04
Last Update Date:2013-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0038162208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD114518OtherCOVENTRY
MD52412402OtherBLUE CROSS BLUE SHIELD
MD072831400Medicaid
MDG1130001OtherBLUE CHOICE
MD52412402OtherBLUE CROSS BLUE SHIELD