Provider Demographics
NPI:1871596502
Name:TAYLOR, MICHAEL A (MD)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:A
Last Name:TAYLOR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:381 W HORTON RD
Mailing Address - Street 2:
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98226-7740
Mailing Address - Country:US
Mailing Address - Phone:360-370-2873
Mailing Address - Fax:360-818-2873
Practice Address - Street 1:381 W HORTON RD
Practice Address - Street 2:
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98226-7740
Practice Address - Country:US
Practice Address - Phone:360-370-2873
Practice Address - Fax:360-818-2873
Is Sole Proprietor?:No
Enumeration Date:2005-05-26
Last Update Date:2022-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD000303222085R0203X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0203XAllopathic & Osteopathic PhysiciansRadiologyTherapeutic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA015132002OtherGROUP HEALTH COOPERATIVE
WAMD3032OtherALASKA MEDICAID
WA71397OtherLABOR AND INDUSTRIES
WAA00691099418298225OtherTRICARE
WA8155178Medicaid
WAP1624928OtherOXFORD HEALTH PLAN
WA920002779OtherRAILROAD MEDICARE
WA02432OtherREGENCE BLUE SHIELD