Provider Demographics
NPI:1982606406
Name:TAYLOR, RICHARD L (MD, FAAN)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:L
Last Name:TAYLOR
Suffix:
Gender:M
Credentials:MD, FAAN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8016 SUNSTONE CIR
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21208-3000
Mailing Address - Country:US
Mailing Address - Phone:443-444-7500
Mailing Address - Fax:443-444-7501
Practice Address - Street 1:8016 SUNSTONE CIR
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21208-3000
Practice Address - Country:US
Practice Address - Phone:410-484-9074
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-08-15
Last Update Date:2022-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDDD00177722084N0600X
MDD00177722084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
No2084N0600XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyClinical Neurophysiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD323911000Medicaid
MD323911000Medicaid
D76381Medicare UPIN