Provider Demographics
NPI:1902117039
Name:TAYLOR, MALENA M (DO)
Entity type:Individual
Prefix:
First Name:MALENA
Middle Name:M
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:PO BOX 7068
Mailing Address - Street 2:
Mailing Address - City:PORTSMOUTH
Mailing Address - State:VA
Mailing Address - Zip Code:23707-0068
Mailing Address - Country:US
Mailing Address - Phone:757-686-3508
Mailing Address - Fax:757-686-0541
Practice Address - Street 1:1925 GLENN MITCHELL DR STE 100
Practice Address - Street 2:
Practice Address - City:VA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23456-0170
Practice Address - Country:US
Practice Address - Phone:757-689-8430
Practice Address - Fax:757-689-8435
Is Sole Proprietor?:No
Enumeration Date:2010-06-23
Last Update Date:2025-01-24
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NC2021-00111207Q00000X
VA0102203609207Q00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine