MEDICARE: PAMELA ANN 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	DR.0030681	CO
2	207RC0000X	Cardiovascular Disease Physician	30681	CO

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	P01025201	OTHER	CO	MCR RAILROAD
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1972508505
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PAMELA ANN TAYLOR M.D.

Provider Business Mailing Address
First Line	:	6011 E WOODMEN RD
Second Line	:	STE 120
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80923-2603
Country	:	US
Telephone Number	:	719-776-8500
Fax Number	:	719-634-1448

Provider Business Practice Location Address
First Line	:	6011 E WOODMEN RD
Second Line	:	STE 120
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80923-2603
Country	:	US
Telephone Number	:	719-776-8500
Fax Number	:	719-634-1448

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

Provider Enumeration Date	:	06/20/2005
Last Update Date	:	10/20/2021

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