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General NPI Number Information
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NPI Number | 1689828162
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Entity Type | Individual
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Provider Name | MICHAEL B. TAYLOR MD
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Gender | Male
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Dates
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Enumeration Date | 11/10/2008
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Last Update Date | 09/23/2024
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Provider Practice Location Address
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Address Line | 520 S EAGLE RD SUITE 3112
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City | MERIDIAN
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State | ID
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Zip | 83642-6351
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Country | US
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Telephone | 208-706-5800
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Fax |
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Provider Business Mailing Address
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Address Line | 875 S VANGUARD WAY STE 200D
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City | MERIDIAN
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State | ID
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Zip | 83642-8540
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Country | US
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Telephone | 208-782-6730
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Fax | 208-759-7822
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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 | 208800000X
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Taxonomy Name | Urology Physician
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License Number | M11650
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License Number State | ID
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