Provider Demographics
NPI:1659602506
Name:TAYLOR, NIGEL E (MD)
Entity Type:Individual
Prefix:
First Name:NIGEL
Middle Name:E
Last Name:TAYLOR
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 1:40 BALDWIN AVE
Mailing Address - Street 2:
Mailing Address - City:LUGOFF
Mailing Address - State:SC
Mailing Address - Zip Code:29078
Mailing Address - Country:US
Mailing Address - Phone:803-669-3461
Mailing Address - Fax:
Practice Address - Street 1:409 E CHURCH ST
Practice Address - Street 2:
Practice Address - City:JEFFERSON
Practice Address - State:SC
Practice Address - Zip Code:29718-8701
Practice Address - Country:US
Practice Address - Phone:843-658-3005
Practice Address - Fax:843-658-7780
Is Sole Proprietor?:No
Enumeration Date:2010-01-15
Last Update Date:2016-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCTL32330207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine