Individual
TAYLOR CARLYLE BAZEMORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1415 PHYSICIANS DR, WILMINGTON, NC 28401-7338
(910) 662-9500
(910) 662-9501
Mailing address
PO BOX 936857, ATLANTA, GA 31193-6857
(910) 662-9500
(910) 662-9501
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
2017-01994
NC
207RC0001X
Clinical Cardiac Electrophysiology Physician
Primary
2017-01994
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1144648270
—
NC
Enumeration date
04/05/2014
Last updated
11/22/2023
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