Provider Demographics
NPI:1154471464
Name:TAYLOR, DAVID EDWARD (PA)
Entity Type:Individual
Prefix:MR
First Name:DAVID
Middle Name:EDWARD
Last Name:TAYLOR
Suffix:
Gender:M
Credentials:PA
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Mailing Address - Street 1:200 MILL RD
Mailing Address - Street 2:SUITE 180
Mailing Address - City:FAIRHAVEN
Mailing Address - State:MA
Mailing Address - Zip Code:02719-5252
Mailing Address - Country:US
Mailing Address - Phone:508-973-2000
Mailing Address - Fax:508-973-2001
Practice Address - Street 1:208 MILL ROAD
Practice Address - Street 2:
Practice Address - City:FAIRHAVEN
Practice Address - State:MA
Practice Address - Zip Code:02719-5252
Practice Address - Country:US
Practice Address - Phone:508-973-2432
Practice Address - Fax:508-973-2435
Is Sole Proprietor?:No
Enumeration Date:2007-01-11
Last Update Date:2014-08-19
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MAAP936363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical