Provider Demographics
NPI:1831283332
Name:TAYLOR, LISA M (MD)
Entity Type:Individual
Prefix:DR
First Name:LISA
Middle Name:M
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:107 COMMERCIAL STREET
Mailing Address - Street 2:
Mailing Address - City:MASHPEE
Mailing Address - State:MA
Mailing Address - Zip Code:02649-6507
Mailing Address - Country:US
Mailing Address - Phone:508-477-7090
Mailing Address - Fax:508-477-7028
Practice Address - Street 1:107 COMMERCIAL STREET
Practice Address - Street 2:COMMUNITY HEALTH CENTER OF CAPE COD, INC.
Practice Address - City:MASHPEE
Practice Address - State:MA
Practice Address - Zip Code:02649-6507
Practice Address - Country:US
Practice Address - Phone:508-477-7090
Practice Address - Fax:508-477-7028
Is Sole Proprietor?:No
Enumeration Date:2006-10-02
Last Update Date:2009-06-01
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MA154383207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA1300369Medicaid
MAA22857Medicare UPIN
MAG51931Medicare UPIN