Provider Demographics
NPI:1427012814
Name:TAYLOR-TYREE, GILL MORGAN SR (MD)
Entity Type:Individual
Prefix:DR
First Name:GILL
Middle Name:MORGAN
Last Name:TAYLOR-TYREE
Suffix:SR
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 1:711 S BOND ST
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21231-3304
Mailing Address - Country:US
Mailing Address - Phone:410-732-5824
Mailing Address - Fax:410-732-5825
Practice Address - Street 1:711 S BOND ST
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21231-3304
Practice Address - Country:US
Practice Address - Phone:410-732-5824
Practice Address - Fax:410-732-5825
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD036005E2085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1063515Medicaid
PA476362Medicare ID - Type Unspecified
PA1063515Medicaid