Healthcare Provider Details

I. General information

NPI: 1154785152
Provider Name (Legal Business Name): NICHOLAS ALEXANDER TAYLOR M.D., PH.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/06/2016
Last Update Date: 03/19/2026
Certification Date: 03/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2417 ATRIUM DR STE 250
RALEIGH NC
27607-6673
US

IV. Provider business mailing address

127 HILLSPRING LN
CHAPEL HILL NC
27516-4010
US

V. Phone/Fax

Practice location:
  • Phone: 757-871-5107
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number218051
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number2021-01225
License Number StateNC
# 3
Primary TaxonomyY
Taxonomy Code207ND0101X
TaxonomyMOHS-Micrographic Surgery Physician
License Number2021-01225
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: