Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Q00000X | Family Doctor | 34.006105 | OH |
N | 207QA0505X | Family Doctor - Adult Medicine | 34.006105 | OH |
NPI | 1265656748 |
---|---|
Provider Name | Dr. James Edward Coulter |
First Address | Troy, MI 48099-1239 |
Second Address | Cincinnati, OH 45212-2246 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/04/2007 |
Last Update Date | 11/07/2013 |