Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Q00000X | Family Doctor | 0101057041 | VA |
N | 207QA0505X | Family Doctor - Adult Medicine | 200100795 | NC |
NPI | 1235179516 |
---|---|
Provider Name | Dr. Robert Pelham Taylor |
First Address | Waynesboro, VA 22980-3629 |
Second Address | Waynesboro, VA 22980-3629 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/06/2006 |
Last Update Date | 08/12/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
129RJ | (05) | NC |
89129RJ | (05) | NC |
E95232 | (02) |