MEDICARE: DR. PAUL TAYLOR LIVENGOOD MD

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	207Q00000X	Family Medicine Physician	11172	WV
2	207Q00000X	Family Medicine Physician	D0023774	MD

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
3	110098979	OTHER	MD	RAILROAD MEDICARE
4	LI0467843	OTHER	WV	WV MEDICARE PROVIDER NUMBER
8	080006019	OTHER	WV	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	P11372	OTHER	MD	BCBS POS
2	1266849	OTHER		UNITED HEALTHCARE
5	W3990003	OTHER	MD	BCBS FEDERAL
6	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
7	00716943	OTHER	WV	BCBS PROVIDER #
9	104012132	OTHER		CIGNA
10	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
11	W399	OTHER	WV	BCBS FEDERAL PIN #
12	0003	OTHER	WV	BCBS FEDERAL GROUP #
13	417071-01	OTHER	MD	BCBS
14	850290	OTHER		MDIPA - OPTIMUM CHOICE

General Provider Information

NPI Number	:	1275598120
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PAUL TAYLOR LIVENGOOD MD

Provider Business Mailing Address
First Line	:	912 SETON DR
Second Line	:
City	:	CUMBERLAND
State	:	MD
Zip	:	21502-1818
Country	:	US
Telephone Number	:	301-722-3111
Fax Number	:	301-722-5135

Provider Business Practice Location Address
First Line	:	912 SETON DR
Second Line	:
City	:	CUMBERLAND
State	:	MD
Zip	:	21502-1818
Country	:	US
Telephone Number	:	301-722-3111
Fax Number	:	301-722-5135

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

Provider Enumeration Date	:	04/20/2006
Last Update Date	:	02/10/2025

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Directions to “ DR. PAUL TAYLOR LIVENGOOD MD” Practice Location

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