Provider Demographics
NPI:1013128693
Name:TAYLOR, MEREDITH L (MD)
Entity Type:Individual
Prefix:DR
First Name:MEREDITH
Middle Name:L
Last Name:TAYLOR
Suffix:
Gender:F
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 775985
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60677-5985
Mailing Address - Country:US
Mailing Address - Phone:317-770-6900
Mailing Address - Fax:317-770-6911
Practice Address - Street 1:14540 PRAIRIE LAKES BLVD N
Practice Address - Street 2:SUITE 102
Practice Address - City:NOBLESVILLE
Practice Address - State:IN
Practice Address - Zip Code:46060-4366
Practice Address - Country:US
Practice Address - Phone:317-770-9353
Practice Address - Fax:317-770-9358
Is Sole Proprietor?:No
Enumeration Date:2007-05-24
Last Update Date:2023-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01066352A208000000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN000000620986OtherANTHEM
IN200935850Medicaid
INM400065185Medicare PIN
IN000000620986OtherANTHEM
IN715530DGGGMedicare PIN
IN177280037Medicare PIN