Provider Demographics
NPI:1770525701
Name:TAYLOR, CARLA MORRIS (MD, FAAP)
Entity type:Individual
Prefix:DR
First Name:CARLA
Middle Name:MORRIS
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:MD, FAAP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4512 KIRKWOOD HWY
Mailing Address - Street 2:SUITE201
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19808-5123
Mailing Address - Country:US
Mailing Address - Phone:302-633-6338
Mailing Address - Fax:302-633-9398
Practice Address - Street 1:4512 KIRKWOOD HWY
Practice Address - Street 2:SUITE101
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19808-5123
Practice Address - Country:US
Practice Address - Phone:302-633-6338
Practice Address - Fax:302-633-9398
Is Sole Proprietor?:No
Enumeration Date:2006-06-12
Last Update Date:2008-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEC10003144208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
DEB57076Medicare UPIN