Healthcare Provider Details

I. General information

NPI: 1346063401
Provider Name (Legal Business Name): DRS HICKEN CRANLEY TAYLOR PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/06/2024
Last Update Date: 11/06/2024
Certification Date: 11/06/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 MEMORIAL AVE
WESTMINSTER MD
21157-5726
US

IV. Provider business mailing address

2360 W JOPPA RD STE 224
LUTHERVILLE MD
21093-4664
US

V. Phone/Fax

Practice location:
  • Phone: 410-644-4379
  • Fax:
Mailing address:
  • Phone: 410-644-4379
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207ZP0102X
TaxonomyAnatomic Pathology & Clinical Pathology Physician
License Number
License Number State

VIII. Authorized Official

Name: CHRISTIAN HANSEN
Title or Position: AUTHORIZED OFFICIAL
Credential:
Phone: 410-644-4379