Provider Demographics
NPI:1194750356
Name:TAYLOR, KATHERINE E (MD)
Entity type:Individual
Prefix:
First Name:KATHERINE
Middle Name:E
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1832 CENTRE STREET
Mailing Address - Street 2:WEST ROXBURY MEDICAL GROUP FAULKNER HOSPITAL
Mailing Address - City:WEST ROXBURY
Mailing Address - State:MA
Mailing Address - Zip Code:02130
Mailing Address - Country:US
Mailing Address - Phone:617-469-4000
Mailing Address - Fax:
Practice Address - Street 1:1832 CENTRE STREET
Practice Address - Street 2:WEST ROXBURY MEDICAL GROUP FAULKNER HOSPITAL
Practice Address - City:WEST ROXBURY
Practice Address - State:MA
Practice Address - Zip Code:02130
Practice Address - Country:US
Practice Address - Phone:617-469-4000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA152545207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine