Provider Demographics
NPI:1770293227
Name:GIANFERMI, TAYLOR ANTHONY
Entity type:Individual
Prefix:
First Name:TAYLOR
Middle Name:ANTHONY
Last Name:GIANFERMI
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 1:262 UPTOWN DR APT 305
Mailing Address - Street 2:
Mailing Address - City:BAY CITY
Mailing Address - State:MI
Mailing Address - Zip Code:48708-5652
Mailing Address - Country:US
Mailing Address - Phone:586-224-0161
Mailing Address - Fax:
Practice Address - Street 1:931 S SAGINAW RD
Practice Address - Street 2:
Practice Address - City:MIDLAND
Practice Address - State:MI
Practice Address - Zip Code:48640-4602
Practice Address - Country:US
Practice Address - Phone:989-631-0910
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-11-23
Last Update Date:2022-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302414905183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist