Basic Information
| Provider Information | |||||||||
| NPI: | 1609135508 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | TAYLOR | ||||||||
| FirstName: | SHEILA | ||||||||
| MiddleName: | E. | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | DO | ||||||||
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| Mailing Information | |||||||||
| Address1: | 200 HYGEIA DRIVE | ||||||||
| Address2: | CCHS PHYSICIAN CONTRACTING, SUITE 2300 | ||||||||
| City: | NEWARK | ||||||||
| State: | DE | ||||||||
| PostalCode: | 197132049 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 501 W. 14TH STREET | ||||||||
| Address2: | WILMINGTON HOSPITAL HEALTH CTR | ||||||||
| City: | WILMINGTON | ||||||||
| State: | DE | ||||||||
| PostalCode: | 198011013 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3024284413 | ||||||||
| FaxNumber: | 3022551225 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/11/2012 | ||||||||
| LastUpdateDate: | 08/22/2017 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | C2-0012289 | DE | N | Allopathic & Osteopathic Physicians | Family Medicine | 207Q00000X | OS018097 | PA | N | Allopathic & Osteopathic Physicians | Family Medicine | 207QS0010X | OS018097 | PA | N | Allopathic & Osteopathic Physicians | Family Medicine | Sports Medicine | 207QS0010X | C2-0012289 | DE | Y | Allopathic & Osteopathic Physicians | Family Medicine | Sports Medicine |
ID Information
| ID | Type | State | Issuer | Description | 103118464 | 05 | PA | MEDICAID |