MEDICARE: DR. STEPHEN TAYLOR D.C.

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	111N00000X	Chiropractor	S01824	MD

General Provider Information

NPI Number	:	1124171608
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. STEPHEN TAYLOR D.C.

Provider Business Mailing Address
First Line	:	17308 HAVERSTRAW CT
Second Line	:
City	:	GERMANTOWN
State	:	MD
Zip	:	20874-2924
Country	:	US
Telephone Number	:	301-540-6657
Fax Number	:

Provider Business Practice Location Address
First Line	:	19110 MONTGOMERY VILLAGE AVE
Second Line	:	SUITE 200
City	:	GAITHERSBURG
State	:	MD
Zip	:	20886-3702
Country	:	US
Telephone Number	:	301-548-9079
Fax Number	:

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

Provider Enumeration Date	:	01/19/2007
Last Update Date	:	07/08/2007

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