Taylor, Charles Russell
Taylor, Charles Russell is an individual health care provider with primary practice located at 50 Staniford St Ste 200 , Boston MA 02114-2543. He recently has only one registered license in Allopathic & Osteopathic Physicians / Dermatology, which is considered as his primary health care specialty. Taylor, Charles Russell can be contacted via phone (617) 726-2914.Contact Information
Primary practice address
50 Staniford St Ste 200
Boston MA 02114-2543
Phone: (617) 726-2914
Fax: (617) 726-7768
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Dermatology | 207N00000X | 60034 | Massachusetts |
Profile Details
| NPI number | 1972593069 |
|---|---|
| LBN Legal business name | Taylor, Charles Russell |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 28th, 2005 |
| Last updated | Jun 3rd, 2021 - about 5 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1972593069 | NPPES |
| Massachusetts | Other | 060034 | TUFTS HEALTH PLAN |
| Massachusetts | Other | J14447 | TUFTS HEALTH PLAN |
| Massachusetts | MEDICAID | 3119211 | TUFTS HEALTH PLAN |
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