MEDICARE: PETER CHARLES 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	207Q00000X	Family Medicine Physician	010125928	VA

General Provider Information

NPI Number	:	1922023118
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PETER CHARLES TAYLOR M.D.

Provider Business Mailing Address
First Line	:	661 W FREDERICK ST
Second Line	:
City	:	STAUNTON
State	:	VA
Zip	:	24401-3104
Country	:	US
Telephone Number	:	360-481-4086
Fax Number	:	540-886-5776

Provider Business Practice Location Address
First Line	:	800 PRESTON AVE
Second Line	:
City	:	CHARLOTTESVILLE
State	:	VA
Zip	:	22903-4420
Country	:	US
Telephone Number	:	434-979-0366
Fax Number	:	434-245-0403

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

Provider Enumeration Date	:	07/12/2006
Last Update Date	:	05/30/2021

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