MEDICARE: GREGORY TAYLOR EDUCATOR

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174H00000X	Health Educator
2	174H00000X	Health Educator		MD

General Provider Information

NPI Number	:	1114408291
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GREGORY TAYLOR EDUCATOR

Provider Business Mailing Address
First Line	:	1400 MERCANTILE LN STE 206
Second Line	:
City	:	LARGO
State	:	MD
Zip	:	20774-5350
Country	:	US
Telephone Number	:	240-462-7983
Fax Number	:	301-966-7529

Provider Business Practice Location Address
First Line	:	1400 MERCANTILE LN STE 206
Second Line	:
City	:	LARGO
State	:	MD
Zip	:	20774-5350
Country	:	US
Telephone Number	:	240-462-7983
Fax Number	:	301-966-7529

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/27/2018
Last Update Date	:	09/15/2025

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