MEDICARE: DR. ALBERT WILLIAM TAYLOR II 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	171000000X	Military Health Care Provider	0101056975	VA

General Provider Information

NPI Number	:	1851381347
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ALBERT WILLIAM TAYLOR II MD

Provider Business Mailing Address
First Line	:	6133 DEER RIDGE TRL
Second Line	:
City	:	SPRINGFIELD
State	:	VA
Zip	:	22150-1040
Country	:	US
Telephone Number	:	703-922-1922
Fax Number	:

Provider Business Practice Location Address
First Line	:	9501 FARRELL RD
Second Line	:
City	:	FORT BELVOIR
State	:	VA
Zip	:	22060-5901
Country	:	US
Telephone Number	:	703-805-9182
Fax Number	:

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

Provider Enumeration Date	:	10/25/2005
Last Update Date	:	07/08/2007

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