Basic Information
Provider Information
NPI: 1376030569
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: TAYLOR
FirstName: WARREN
MiddleName: MICHAEL
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 3600 FORBES AVENUE
Address2: FORBES TOWER-PLAZA LEVEL SUITE 140
City: PITTSBURGH
State: PA
PostalCode: 15213
CountryCode: US
TelephoneNumber: 8016625701
FaxNumber:  
Practice Location
Address1: 4401 PENN AVE
Address2: PEDIATRIC CRITICAL CARE MEDICINE SUITE 02000
City: PITTSBURGH
State: PA
PostalCode: 15224
CountryCode: US
TelephoneNumber: 4126926076
FaxNumber:  
Other Information
ProviderEnumerationDate: 04/13/2018
LastUpdateDate: 07/12/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 07/12/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
208000000X11405545-1205UTY Allopathic & Osteopathic PhysiciansPediatrics 

No ID Information.


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