Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XS0106X | Orthopaedic Hand Surgeon | ME113317 | FL |
NPI | 1306052527 |
---|---|
Provider Name | Alexander Chisolm Coleman |
First Address | Gulf Breeze, FL 32561-7809 |
Second Address | Gulf Breeze, FL 32561-7809 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/05/2007 |
Last Update Date | 10/12/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
006377300 | (05) | FL |
141061 | (05) | AL |
14LU9 | BLUE CROSS BLUE SHIELD (01) | FL |
592-17944 | BLUE CROSS BLUE SHIELD (01) | AL |
592-18009 | BLUE CROSS BLUE SHIELD (01) | FL |