Provider Demographics
NPI:1710982566
Name:TAYLOR, STUART B (MD)
Entity Type:Individual
Prefix:DR
First Name:STUART
Middle Name:B
Last Name:TAYLOR
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:903 RUSSELL AVE
Mailing Address - Street 2:STE 301
Mailing Address - City:GAITHERSBURG
Mailing Address - State:MD
Mailing Address - Zip Code:20879-3257
Mailing Address - Country:US
Mailing Address - Phone:301-869-2292
Mailing Address - Fax:301-869-4223
Practice Address - Street 1:903 RUSSELL AVE
Practice Address - Street 2:STE 301
Practice Address - City:GAITHERSBURG
Practice Address - State:MD
Practice Address - Zip Code:20879-3257
Practice Address - Country:US
Practice Address - Phone:301-869-2292
Practice Address - Fax:301-869-4223
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-17
Last Update Date:2012-06-04
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Provider Licenses
StateLicense IDTaxonomies
MDD0033342208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD147861300Medicaid
D78183Medicare UPIN