Healthcare Provider Details

I. General information

NPI: 1295045755
Provider Name (Legal Business Name): ELAINE TAYLOR MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/18/2010
Last Update Date: 10/03/2025
Certification Date: 10/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5457 TWINS KNOLLS RD STE 300-S6
COLUMBIA MD
21045-3259
US

IV. Provider business mailing address

5457 TWIN KNOLLS RD STE 300-S6
COLUMBIA MD
21045-3259
US

V. Phone/Fax

Practice location:
  • Phone: 301-602-4658
  • Fax:
Mailing address:
  • Phone: 301-602-4658
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RG0300X
TaxonomyGeriatric Medicine (Internal Medicine) Physician
License NumberR229326
License Number StateMD
# 2
Primary TaxonomyY
Taxonomy Code2081P0301X
TaxonomyBrain Injury Medicine (Physical Medicine & Rehabilitation) Physician
License Number020336
License Number StateOH
# 3
Primary TaxonomyN
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License NumberR229326
License Number StateMD
# 4
Primary TaxonomyN
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number020336
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: