Provider Demographics
NPI:1639102247
Name:TROISCHT, TAYLOR SOMERS (MD)
Entity Type:Individual
Prefix:
First Name:TAYLOR
Middle Name:SOMERS
Last Name:TROISCHT
Suffix:
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:PO BOX 1127
Mailing Address - Street 2:
Mailing Address - City:MORGANTOWN
Mailing Address - State:WV
Mailing Address - Zip Code:26507-1127
Mailing Address - Country:US
Mailing Address - Phone:304-598-4032
Mailing Address - Fax:304-598-4143
Practice Address - Street 1:608 CHEAT RD
Practice Address - Street 2:
Practice Address - City:MORGANTOWN
Practice Address - State:WV
Practice Address - Zip Code:26508-4210
Practice Address - Country:US
Practice Address - Phone:304-594-1313
Practice Address - Fax:304-594-2408
Is Sole Proprietor?:No
Enumeration Date:2006-07-08
Last Update Date:2022-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV21570208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD405728700Medicaid
PA1012398360001Medicaid
WV1812795000Medicaid
PA1012398360001Medicaid