Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207K00000X | Allergist & Immunologist | 4301505653 | MI |
N | 207KA0200X | Allergist | MD61042543 | WA |
NPI | 1265826523 |
---|---|
Provider Name | David Thomas Coleman |
First Address | Seattle, WA 98145-5095 |
Second Address | Detroit, MI 48202-3141 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 25/03/2015 |
Last Update Date | 28/09/2021 |