Provider Demographics
NPI:1295726909
Name:TAYLOR, DONALD M (MD)
Entity type:Individual
Prefix:DR
First Name:DONALD
Middle Name:M
Last Name:TAYLOR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:1629 W BIG BEAVER RD
Mailing Address - Street 2:
Mailing Address - City:TROY
Mailing Address - State:MI
Mailing Address - Zip Code:48084-3501
Mailing Address - Country:US
Mailing Address - Phone:248-649-2266
Mailing Address - Fax:248-649-7246
Practice Address - Street 1:1629 W BIG BEAVER RD
Practice Address - Street 2:
Practice Address - City:TROY
Practice Address - State:MI
Practice Address - Zip Code:48084-3501
Practice Address - Country:US
Practice Address - Phone:248-649-2266
Practice Address - Fax:248-649-7246
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301030829207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1745257Medicaid
A76429Medicare UPIN
MI1745257Medicaid