Provider Demographics
NPI:1235021494
Name:TAYLOR, MAX WILLIAM (FNP)
Entity type:Individual
Prefix:
First Name:MAX
Middle Name:WILLIAM
Last Name:TAYLOR
Suffix:
Gender:M
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:616 E 33RD ST
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21218-3504
Mailing Address - Country:US
Mailing Address - Phone:910-988-4426
Mailing Address - Fax:
Practice Address - Street 1:4601 PALL MALL RD
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21215-6414
Practice Address - Country:US
Practice Address - Phone:410-664-5551
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-21
Last Update Date:2025-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR242985363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily