Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | 01040221A | IN |
N | 207XX0004X | Foot and Ankle Orthopaedic Surgeon | 01040221A | IN |
NPI | 1366442618 |
---|---|
Provider Name | Brian E Coleman |
First Address | Delray Beach, FL 33445-6584 |
Second Address | Delray Beach, FL 33445-6584 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/07/2005 |
Last Update Date | 03/09/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000000386686 | ANTHEM BCBS (01) | IN |
200010680 | (05) | IN |
234270A | MEDICARE INDIVDUAL PROVID (01) | IN |
F28036 | (02) |