Individual
JANICE K COATES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
100 MICHIGAN ST NE, GRAND RAPIDS, MI 49503-2560
(616) 391-0690
Mailing address
100 MICHIGAN ST NE, MC 845, GRAND RAPIDS, MI 49503-2560
Taxonomy
Speciality
Code
Description
License number
State
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
5101010301
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1558407189
GROUP NPI
MI
01
—
1922090554
GROUP NPI
MI
01
—
350D176310
BCBS GROUP
MI
05
—
4478676
—
MI
01
—
5101010301
STATE LICENSE
MI
Enumeration date
12/18/2006
Last updated
02/06/2012
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