Provider Demographics
NPI:1811104961
Name:TAYLOR, SHERRI KEARISE (MD)
Entity type:Individual
Prefix:DR
First Name:SHERRI
Middle Name:KEARISE
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:PO BOX 743904
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30374-3904
Mailing Address - Country:US
Mailing Address - Phone:803-545-5700
Mailing Address - Fax:803-434-4699
Practice Address - Street 1:2 MEDICAL PARK ROAD LL9/10
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29203-6839
Practice Address - Country:US
Practice Address - Phone:803-545-5700
Practice Address - Fax:803-434-6642
Is Sole Proprietor?:No
Enumeration Date:2007-05-17
Last Update Date:2025-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD429276207V00000X
AL28454207V00000X
GA101533207VM0101X
SC51613207VM0101X
MI4301505536207VM0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VM0101XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyMaternal & Fetal Medicine
No207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL009912762Medicaid
AL009912761Medicaid
AL51545430OtherBCBS-1610 CENTER
SC516132Medicaid
AL51545431OtherBCBS-1720 CENTER