MEDICARE: TAYLOR ADAM CARTER MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207L00000X	Anesthesiology Physician	LL52645	SC

General Provider Information

NPI Number	:	1124511332
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TAYLOR ADAM CARTER MD

Provider Business Mailing Address
First Line	:	169 ASHLEY AVE RM 202
Second Line	:
City	:	CHARLESTON
State	:	SC
Zip	:	29425-8905
Country	:	US
Telephone Number	:	843-792-2322
Fax Number	:

Provider Business Practice Location Address
First Line	:	1928 STAFFWOOD RD
Second Line	:
City	:	JOHNS ISLAND
State	:	SC
Zip	:	29455-8223
Country	:	US
Telephone Number	:	318-423-0436
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/12/2018
Last Update Date	:	06/12/2018

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