Basic Information
| Provider Information | |||||||||
| NPI: | 1063630457 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | TAYLOR AND OSTERMAN, PA | ||||||||
| LastName: | |||||||||
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| Mailing Information | |||||||||
| Address1: | 8630 FENTON ST | ||||||||
| Address2: | SUITE 1 | ||||||||
| City: | SILVER SPRING | ||||||||
| State: | MD | ||||||||
| PostalCode: | 209103806 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3015875666 | ||||||||
| FaxNumber: | 3015894479 | ||||||||
| Practice Location | |||||||||
| Address1: | 8630 FENTON ST | ||||||||
| Address2: | SUITE 1 | ||||||||
| City: | SILVER SPRING | ||||||||
| State: | MD | ||||||||
| PostalCode: | 209103806 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3015875666 | ||||||||
| FaxNumber: | 3015894479 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/23/2007 | ||||||||
| LastUpdateDate: | 04/29/2008 | ||||||||
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| AuthorizedOfficialLastName: | TAYLOR | ||||||||
| AuthorizedOfficialFirstName: | PAUL | ||||||||
| AuthorizedOfficialMiddleName: | M | ||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 3015875666 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
| AuthorizedOfficialNameSuffix: | |||||||||
| AuthorizedOfficialCredential: | DPM | ||||||||
| NPICertificationDate: | |||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 213E00000X | 00310 | MD | Y | 193400000X SINGLE SPECIALTY GROUP | Podiatric Medicine & Surgery Service Providers | Podiatrist |
ID Information
| ID | Type | State | Issuer | Description | 480019823 | 01 | RAILROAD PIN | OTHER | 480015248 | 01 | RAILROAD PIN | OTHER |