Individual
MARK M TAYLOR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
511 ROANOKE BLVD, SUITE 3, SALEM, VA 24153-5032
(540) 375-2686
(540) 375-2688
Mailing address
511 ROANOKE BLVD, SUITE 3, SALEM, VA 24153-5032
(540) 375-2686
(540) 375-2688
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
0101058096
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
005618541
—
VA
Enumeration date
02/10/2006
Last updated
08/08/2014
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