Healthcare Provider Details

I. General information

NPI: 1821355355
Provider Name (Legal Business Name): JANELLE TAYLOR-THOMAS M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/22/2012
Last Update Date: 08/18/2021
Certification Date: 08/18/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4175 N HANSON CT STE 209 DEPARTMENT OF OBSTETRICS AND GYNECOLOGY
BOWIE MD
20716-3184
US

IV. Provider business mailing address

201 DEFENSE HWY SUITE 100
ANNAPOLIS MD
21401-8943
US

V. Phone/Fax

Practice location:
  • Phone: 301-352-4007
  • Fax: 301-352-3116
Mailing address:
  • Phone: 443-481-3354
  • Fax: 443-481-6515

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberD81801
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: