Provider Demographics
NPI:1457325094
Name:TAYLOR, PAUL M (DPM)
Entity Type:Individual
Prefix:
First Name:PAUL
Middle Name:M
Last Name:TAYLOR
Suffix:
Gender:M
Credentials:DPM
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Mailing Address - Street 1:10901 CONNECTICUT AVE
Mailing Address - Street 2:SUITE 300
Mailing Address - City:KENSINGTON
Mailing Address - State:MD
Mailing Address - Zip Code:20895-1645
Mailing Address - Country:US
Mailing Address - Phone:301-933-7133
Mailing Address - Fax:301-933-7137
Practice Address - Street 1:8630 FENTON ST
Practice Address - Street 2:SUITE 1
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20910-3806
Practice Address - Country:US
Practice Address - Phone:301-587-5666
Practice Address - Fax:301-589-4479
Is Sole Proprietor?:No
Enumeration Date:2006-02-13
Last Update Date:2014-11-25
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Provider Licenses
StateLicense IDTaxonomies
MD00310213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD080116000Medicaid
110179YFCTMedicare PIN
DC5068600001Medicare NSC
T30888Medicare UPIN