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Individual
MARK E TAYLOR
Active
Individual
MARK E TAYLOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
055797
GA
207Q00000X
Family Medicine Physician
Primary
37534
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000467519A
—
GA
05
—
000471809A
—
GA
05
—
000471809B
—
GA
05
—
000471809C
—
GU
01
—
10060509
AMERIGROUP
GA
01
—
341628
WELLCARE MCAID
GA
01
—
341629
WELLCARE
GA
01
—
341630
WELLCARE MCAID
GA
01
—
342410
WELLCARE MCAID
GA
05
—
980939645C
—
GA
05
—
980939645E
—
GA
05
—
980939645F
—
GA
05
—
980939645G
—
GA
Enumeration date
08/18/2005
Last updated
10/19/2015
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