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General NPI Number Information
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NPI Number | 1104956770
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Entity Type | Individual
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Provider Name | DARLENE C IFILL TAYLOR MD
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Gender | Female
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Dates
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Enumeration Date | 03/06/2007
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Last Update Date | 12/03/2024
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Provider Practice Location Address
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Address Line | 1515 MOCKINGBIRD LN STE 360
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City | CHARLOTTE
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State | NC
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Zip | 28209-1172
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Country | US
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Telephone | 980-938-5001
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Fax | 980-999-5022
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Provider Business Mailing Address
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Address Line | 1515 MOCKINGBIRD LN STE 360
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City | CHARLOTTE
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State | NC
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Zip | 28209-1172
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Country | US
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Telephone | 980-938-5001
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Fax | 980-999-5022
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | DO038044
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | MD18238
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License Number State | DC
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Taxonomy #3
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 2015-00980
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License Number State | NC
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