Individual ProviderMichelle TaylorHospitalistAllopathic & Osteopathic PhysiciansPractice Address450 Northside Cherokee Blvd, Canton, GA 30115-8015(770) 224-1000(770) 720-5100PECOS EnrollmentBased on the most recent information from CMS, provider Michelle Taylor is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.Part BMedicare Part BEnrolledHHAHome Health AgencyEnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceEnrolledCMS last updated its PECOS records today at 9:43 AM.Profile DetailsProvider ID1417144957Provider TypeIndividualFull NameTaylor, MichelleCredentialMDGenderFemaleSole ProprietorNoEnumeration Date9/28/2007Last Updated1/7/2022Contact InformationPractice LocationPractice Address450 Northside Cherokee Blvd, Canton, GA 30115-8015Phone(770) 224-1000Fax(770) 224-2451Mailing LocationMailing Address201 Hospital Rd, Canton, GA 30114-2408Phone(770) 720-5100Fax(404) 851-6325Provider TaxonomiesCodeDescriptionLicenseCode208M00000XPrimaryDescriptionHospitalistAllopathic & Osteopathic PhysiciansLicense060104GeorgiaCode207R00000XDescriptionInternal MedicineAllopathic & Osteopathic PhysiciansLicenseTP07036GeorgiaCode207R00000XDescriptionInternal MedicineAllopathic & Osteopathic PhysiciansLicense060104GeorgiaProvider IdentifiersIDDescriptionIssuerID585076459IDescriptionMedicaidIssuerUnlistedGeorgiaIDTP07036DescriptionOtherIssuerTEMP LICENSEGeorgia