Individual
NATHAN SAMUEL TAYLOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1414 W FAIR AVE, SUITE 190, MARQUETTE, MI 49855-2675
(906) 225-1321
(905) 228-9371
Mailing address
1414 W FAIR AVE, SUITE 190, MARQUETTE, MI 49855-2675
(906) 225-1321
(905) 228-9371
Taxonomy
Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
4301096709
MI
2082S0105X
Surgery of the Hand (Plastic Surgery) Physician
Primary
4301096709
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0520253
BLUE CROSS BLUE SHIELD MI
MI
05
—
1013111897
—
MI
Enumeration date
06/13/2007
Last updated
02/29/2012
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