Provider Demographics
NPI:1912143389
Name:TAYLOR, TAMEKA PARHAM (DPM)
Entity Type:Individual
Prefix:DR
First Name:TAMEKA
Middle Name:PARHAM
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:MRS
Other - First Name:TAMEKA
Other - Middle Name:PARHAM
Other - Last Name:TAYLOR
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:34421 FONTANA DR
Mailing Address - Street 2:
Mailing Address - City:STERLING HEIGHTS
Mailing Address - State:MI
Mailing Address - Zip Code:48312-5776
Mailing Address - Country:US
Mailing Address - Phone:586-819-9194
Mailing Address - Fax:
Practice Address - Street 1:29425 NORTHWESTERN HWY STE 125
Practice Address - Street 2:
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48034-1083
Practice Address - Country:US
Practice Address - Phone:248-621-4800
Practice Address - Fax:248-557-2781
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-06
Last Update Date:2020-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5901002243213EP1101X, 213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
No213EP1101XPodiatric Medicine & Surgery Service ProvidersPodiatristPrimary Podiatric Medicine