Individual
SUSAN C. TAYLOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
932 PINE ST, PHILADELPHIA, PA 19107-6128
(215) 829-6861
(215) 351-3926
Mailing address
800 WALNUT ST, FL 16, PHILADELPHIA, PA 19107-5176
(215) 829-6861
(215) 351-3926
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
MD031488E
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
150874
BLUE SHIELD
PA
01
—
2077149000
KEYSTONE HEALTH PLAN EAST
PA
Enumeration date
02/16/2007
Last updated
02/10/2016
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