Provider Demographics
NPI:1831535202
Name:TAYLOR, ASHLEY MABINA (MD)
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:MABINA
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:ASHLEY
Other - Middle Name:
Other - Last Name:MABINA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:5002 WATERS AVE
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31404-6226
Mailing Address - Country:US
Mailing Address - Phone:912-350-8180
Mailing Address - Fax:912-350-5697
Practice Address - Street 1:5002 WATERS AVE
Practice Address - Street 2:
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31404-6226
Practice Address - Country:US
Practice Address - Phone:912-350-8180
Practice Address - Fax:912-350-5697
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-13
Last Update Date:2020-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA077289208000000X
NC191839390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program