MEDICARE: MARSHA R TAYLOR-ANDEMICHAEL DDS

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	122300000X	Dentist	9660	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1326078825
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARSHA R TAYLOR-ANDEMICHAEL DDS

Provider Business Mailing Address
First Line	:	70 CRAPE MYRTLE DR STE 104
Second Line	:	COMMWELL HEALTH
City	:	BENSON
State	:	NC
Zip	:	27504-8034
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	70 CRAPE MYRTLE DR STE 104
Second Line	:	COMMWELL HEALTH
City	:	BENSON
State	:	NC
Zip	:	27504-8034
Country	:	US
Telephone Number	:	919-938-0875
Fax Number	:

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

Provider Enumeration Date	:	07/03/2006
Last Update Date	:	06/10/2014

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