Provider Demographics
NPI:1053393900
Name:TAYLOR, RONALD S (MD)
Entity type:Individual
Prefix:DR
First Name:RONALD
Middle Name:S
Last Name:TAYLOR
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:3535 W 13 MILE RD
Mailing Address - Street 2:STE 437
Mailing Address - City:ROYAL OAK
Mailing Address - State:MI
Mailing Address - Zip Code:48073-6710
Mailing Address - Country:US
Mailing Address - Phone:248-288-2210
Mailing Address - Fax:248-280-0505
Practice Address - Street 1:3535 W 13 MILE RD
Practice Address - Street 2:STE 437
Practice Address - City:ROYAL OAK
Practice Address - State:MI
Practice Address - Zip Code:48073-6710
Practice Address - Country:US
Practice Address - Phone:248-288-2210
Practice Address - Fax:248-280-0505
Is Sole Proprietor?:No
Enumeration Date:2005-11-16
Last Update Date:2009-12-17
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Provider Licenses
StateLicense IDTaxonomies
MI4301034263208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1232841Medicaid
MI1232841Medicaid
0F36058002Medicare ID - Type Unspecified