Provider Demographics
NPI:1992365720
Name:DEGIULIO, TAYLOR JONES (MD)
Entity Type:Individual
Prefix:
First Name:TAYLOR
Middle Name:JONES
Last Name:DEGIULIO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:TAYLOR
Other - Middle Name:CLAIRE
Other - Last Name:JONES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:3535 W 13 MILE RD STE 329
Mailing Address - Street 2:
Mailing Address - City:ROYAL OAK
Mailing Address - State:MI
Mailing Address - Zip Code:48073-6770
Mailing Address - Country:US
Mailing Address - Phone:248-551-0845
Mailing Address - Fax:248-551-3130
Practice Address - Street 1:3535 W 13 MILE RD STE 329
Practice Address - Street 2:
Practice Address - City:ROYAL OAK
Practice Address - State:MI
Practice Address - Zip Code:48073-6770
Practice Address - Country:US
Practice Address - Phone:248-551-0845
Practice Address - Fax:248-551-3130
Is Sole Proprietor?:No
Enumeration Date:2019-06-14
Last Update Date:2019-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4351044553207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology