Provider Demographics
NPI:1366518565
Name:TAYLOR, JOVONSIA M (MD)
Entity type:Individual
Prefix:DR
First Name:JOVONSIA
Middle Name:M
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:4 W ROLLING XRDS STE 100
Mailing Address - Street 2:
Mailing Address - City:CATONSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21228-6277
Mailing Address - Country:US
Mailing Address - Phone:410-869-0100
Mailing Address - Fax:410-601-7317
Practice Address - Street 1:4 W ROLLING XRDS STE 100
Practice Address - Street 2:
Practice Address - City:CATONSVILLE
Practice Address - State:MD
Practice Address - Zip Code:21228-6277
Practice Address - Country:US
Practice Address - Phone:410-869-0100
Practice Address - Fax:410-601-7317
Is Sole Proprietor?:No
Enumeration Date:2006-11-28
Last Update Date:2024-02-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
DCMD32561208000000X
MDD56744208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
H47847Medicare UPIN
013580K92Medicare ID - Type Unspecified