Provider Demographics
NPI:1568842797
Name:TAYLOR, MATTHEW D (MD)
Entity type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:D
Last Name:TAYLOR
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:PO BOX #1075
Mailing Address - Street 2:76 FORT EDDY RD. SUITE 1
Mailing Address - City:CONCORD
Mailing Address - State:NH
Mailing Address - Zip Code:03301
Mailing Address - Country:US
Mailing Address - Phone:501-229-9346
Mailing Address - Fax:603-326-7600
Practice Address - Street 1:PO BOX #1075
Practice Address - Street 2:76 FORT EDDY RD. SUITE 1
Practice Address - City:CONCORD
Practice Address - State:NH
Practice Address - Zip Code:03301
Practice Address - Country:US
Practice Address - Phone:501-229-9346
Practice Address - Fax:603-326-7600
Is Sole Proprietor?:No
Enumeration Date:2015-06-03
Last Update Date:2025-05-23
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MI4301501292207Q00000X, 207Q00000X
FLTPME3888207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH34220OtherSTATE LICENSE
IL036173713OtherSTATE LICENSE
MI4301501292OtherSTATE LICENSE
FLTPME3888OtherSTATE LICENSE