# KOFI SHAW-TAYLOR MD PA WESTSIDE MEDICAL GROUP

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1265662795
- **Authorized official:** DR. KOFI SHAW-TAYLOR MD (OWNER)
- **Authorized official phone:** (410) 922-7382

## Contact information

- **Practice address:** 2600 LIBERTY HEIGHTS AVE, BALTIMORE, MD 21215-7804
- **Practice address phone:** (410) 922-7382
- **Practice address fax:** (410) 922-7384
- **Mailing address:** 801 KEY HIGHWAY, STE 211 BLDG 1, BALTIMORE, MD 21230
- **Mailing address phone:** (410) 922-7382
- **Mailing address fax:** (410) 922-7384

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207R00000X | Internal Medicine Physician | — | NULL | Yes |
| 207R00000X | Internal Medicine Physician | — | — | Yes |
| 208800000X | Urology Physician | — | NULL | — |
| 208800000X | Urology Physician | — | — | — |

## Other

- **Enumeration date:** 07/17/2009
- **Last updated:** 10/19/2009