Healthcare Provider Details

I. General information

NPI: 1689698920
Provider Name (Legal Business Name): STEVEN JAMES TAYLOR MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/27/2006
Last Update Date: 03/14/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2094 COUNTRY MANOR DR
MOUNT PLEASANT SC
29466-7411
US

IV. Provider business mailing address

2094 COUNTRY MANOR DR
MOUNT PLEASANT SC
29466-7411
US

V. Phone/Fax

Practice location:
  • Phone: 843-884-0073
  • Fax: 843-884-0203
Mailing address:
  • Phone: 843-884-0073
  • Fax: 843-884-0203

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number006754
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: