Provider Demographics
NPI:1093343584
Name:POLK, TAYLOR HARRISON (MD)
Entity Type:Individual
Prefix:DR
First Name:TAYLOR
Middle Name:HARRISON
Last Name:POLK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2200 CROW LN
Mailing Address - Street 2:
Mailing Address - City:MYRTLE BEACH
Mailing Address - State:SC
Mailing Address - Zip Code:29577-1663
Mailing Address - Country:US
Mailing Address - Phone:843-848-5300
Mailing Address - Fax:843-848-5305
Practice Address - Street 1:2200 CROW LN
Practice Address - Street 2:
Practice Address - City:MYRTLE BEACH
Practice Address - State:SC
Practice Address - Zip Code:29577-1663
Practice Address - Country:US
Practice Address - Phone:843-848-5300
Practice Address - Fax:843-848-5305
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-30
Last Update Date:2023-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC90484207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine