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Individual
MICHAEL S COLEMAN
Active
Individual
MICHAEL S COLEMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.A.
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
004854
GA
363AM0700X
Medical Physician Assistant
PA04354
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01050710
AMERIGROUP
GA
05
—
194202142C
—
GA
05
—
194202142D
—
GA
01
—
346495
WELLCARE
GA
01
—
8N8242
BCBS
TX
Enumeration date
07/03/2006
Last updated
12/19/2008
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