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Individual

JULIE A TAYLOR

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
710 DEWITT DR, LUGOFF, SC 29078-9069
(803) 438-7566
(803) 438-4371
Mailing address
PO BOX 1259, SENTINEL HEALTH PARTNERS PA, CAMDEN, SC 29021-1259
(803) 713-8350
(803) 713-8433

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
18239
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
110234248
RAILROAD MEDICARE PIN
SC
05
182395
SC
01
B6606
MEDCOST PIN
Enumeration date
05/17/2006
Last updated
02/24/2012
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