Individual
MATTHEW G TAYLOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3200 CHANNING WAY STE 205, IDAHO FALLS, ID 83404-7546
(208) 535-4580
(208) 535-4520
Mailing address
PO BOX 277381, ATLANTA, GA 30384-7381
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
51784071205
UT
207R00000X
Internal Medicine Physician
2011018390
MO
207RC0000X
Cardiovascular Disease Physician
M12933
ID
207RC0001X
Clinical Cardiac Electrophysiology Physician
Primary
M-12933
ID
Other
Enumeration date
07/28/2006
Last updated
09/24/2024
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