Provider Demographics
NPI:1558370619
Name:TAYLOR, BRENDA CARTER (MD)
Entity Type:Individual
Prefix:
First Name:BRENDA
Middle Name:CARTER
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:806 SAINT VINCENTS DR
Mailing Address - Street 2:SUITE 430
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35205-1684
Mailing Address - Country:US
Mailing Address - Phone:205-939-2806
Mailing Address - Fax:
Practice Address - Street 1:806 SAINT VINCENTS DR
Practice Address - Street 2:SUITE 430
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35205-1684
Practice Address - Country:US
Practice Address - Phone:205-939-2806
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-07
Last Update Date:2012-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL14306207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
E41850Medicare UPIN
AL51551082Medicare PIN