Provider Demographics
NPI:1346234408
Name:TAYLOR, WILLIAM M (MD)
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:M
Last Name:TAYLOR
Suffix:
Gender:M
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:PO BOX 20169
Mailing Address - Street 2:
Mailing Address - City:ROANOKE
Mailing Address - State:VA
Mailing Address - Zip Code:24018-0506
Mailing Address - Country:US
Mailing Address - Phone:540-767-2700
Mailing Address - Fax:540-767-2708
Practice Address - Street 1:2131 S 17TH ST
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28401-7407
Practice Address - Country:US
Practice Address - Phone:910-343-7074
Practice Address - Fax:910-343-7829
Is Sole Proprietor?:No
Enumeration Date:2005-09-06
Last Update Date:2024-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD432424207ZP0102X, 207ZP0102X
NC2024-01897207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA249211OtherUNISON-WMG
PA7492122OtherAETNA
PA30124659OtherAMERIHEALTH MERCY - WSRH
PA001800223Medicaid
PA50080019OtherCAPITAL BLUE CROSS-WMG
PA119719OtherGEISINGER HEALTH PLAN
PA30156218OtherAMERIHEALTH CARITAS - GH
NY02151820Medicaid
PA20080281OtherAMERIHEALTH MERCY-WMG
PA212123OtherJOHNS HOPKINS
PA569078OtherHIGHMARK BLUE SHEILD
PA212123OtherJOHNS HOPKINS
PA30156218OtherAMERIHEALTH CARITAS - GH
PA7492122OtherAETNA
PA50080019OtherCAPITAL BLUE CROSS-WMG
NYCC1117Medicare ID - Type Unspecified
PA131685GVQMedicare PIN