Healthcare Provider Details

I. General information

NPI: 1982606406
Provider Name (Legal Business Name): RICHARD L TAYLOR M.D., F.A.A.N.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/15/2005
Last Update Date: 11/21/2022
Certification Date: 11/21/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8016 SUNSTONE CIR
BALTIMORE MD
21208-3000
US

IV. Provider business mailing address

8016 SUNSTONE CIR
BALTIMORE MD
21208-3000
US

V. Phone/Fax

Practice location:
  • Phone: 410-484-9074
  • Fax:
Mailing address:
  • Phone: 443-444-7500
  • Fax: 443-444-7501

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084N0600X
TaxonomyClinical Neurophysiology Physician
License NumberDD0017772
License Number StateMD
# 2
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License NumberD0017772
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: