MEDICARE: SHAYNE SEBOLD TAYLOR M.D.

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	207R00000X	Internal Medicine Physician	1016276	MA

General Provider Information

NPI Number	:	1811316045
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHAYNE SEBOLD TAYLOR M.D.

Provider Business Mailing Address
First Line	:	243 KING ST STE 238
Second Line	:
City	:	NORTHAMPTON
State	:	MA
Zip	:	01060-2451
Country	:	US
Telephone Number	:	413-288-5146
Fax Number	:	413-352-0707

Provider Business Practice Location Address
First Line	:	17 RESEARCH DRIVE
Second Line	:
City	:	AMHERST
State	:	MA
Zip	:	01002-2178
Country	:	US
Telephone Number	:	413-549-8400
Fax Number	:	413-549-8409

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

Provider Enumeration Date	:	04/15/2014
Last Update Date	:	01/16/2025

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