Provider Demographics
NPI:1386059426
Name:TAYLOR, AMBER (MD)
Entity type:Individual
Prefix:
First Name:AMBER
Middle Name:
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:BLDG 99, UNIT 5024
Mailing Address - Street 2:MISAWA AB
Mailing Address - City:APO
Mailing Address - State:AP
Mailing Address - Zip Code:96319
Mailing Address - Country:US
Mailing Address - Phone:315-226-6111
Mailing Address - Fax:
Practice Address - Street 1:UNIT 2022
Practice Address - Street 2:
Practice Address - City:APO
Practice Address - State:AP
Practice Address - Zip Code:96264-2022
Practice Address - Country:US
Practice Address - Phone:315-782-2273
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-06-27
Last Update Date:2023-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE29964207Q00000X
NE7340207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine