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General NPI Number Information
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NPI Number | 1902117039
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Entity Type | Individual
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Provider Name | MALENA M TAYLOR DO
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Gender | Female
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Dates
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Enumeration Date | 06/23/2010
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Last Update Date | 01/24/2025
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Provider Practice Location Address
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Address Line | 1925 GLENN MITCHELL DR STE 100
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City | VA BEACH
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State | VA
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Zip | 23456-0170
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Country | US
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Telephone | 757-689-8430
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Fax | 757-689-8435
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Provider Business Mailing Address
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Address Line | PO BOX 7068
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City | PORTSMOUTH
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State | VA
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Zip | 23707-0068
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Country | US
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Telephone | 757-686-3508
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Fax | 757-686-0541
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 2021-00111
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 0102203609
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License Number State | VA
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