Provider Demographics
NPI:1841372018
Name:REED, TAYLOR (PA)
Entity type:Individual
Prefix:
First Name:TAYLOR
Middle Name:
Last Name:REED
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9900 GREENBELT RD
Mailing Address - Street 2:SUITE 310
Mailing Address - City:LANHAM
Mailing Address - State:MD
Mailing Address - Zip Code:20706-2255
Mailing Address - Country:US
Mailing Address - Phone:917-453-0746
Mailing Address - Fax:
Practice Address - Street 1:JHBMC - DEPT. OF SURGERY 4940 EASTERN AVE
Practice Address - Street 2:ROOM566
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21224-2735
Practice Address - Country:US
Practice Address - Phone:410-550-6182
Practice Address - Fax:410-550-0633
Is Sole Proprietor?:No
Enumeration Date:2006-10-19
Last Update Date:2008-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY006530363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant