Healthcare Provider Details

I. General information

NPI: 1801846217
Provider Name (Legal Business Name): GREGG WILLIAM TAYLOR M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/10/2006
Last Update Date: 08/25/2021
Certification Date: 08/25/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1126 N CHURCH ST STE 300
GREENSBORO NC
27401-1000
US

IV. Provider business mailing address

1200 N ELM ST
GREENSBORO NC
27401-1004
US

V. Phone/Fax

Practice location:
  • Phone: 336-547-1700
  • Fax:
Mailing address:
  • Phone: 336-832-7000
  • Fax: 336-851-8427

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number9900697
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number9900697
License Number StateNC
# 3
Primary TaxonomyY
Taxonomy Code207RC0001X
TaxonomyClinical Cardiac Electrophysiology Physician
License Number9900697
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: