Provider Demographics
NPI:1720851744
Name:TAYLOR, WILLIAMSON ALFRED
Entity Type:Individual
Prefix:
First Name:WILLIAMSON
Middle Name:ALFRED
Last Name:TAYLOR
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14000 CASTLE BLVD APT 807
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20904-4640
Mailing Address - Country:US
Mailing Address - Phone:240-481-6350
Mailing Address - Fax:
Practice Address - Street 1:14000 CASTLE BLVD APT 807
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20904-4640
Practice Address - Country:US
Practice Address - Phone:240-481-6350
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-01
Last Update Date:2023-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator