Individual
SHANE M COLEMAN
Active
Individual
SHANE M COLEMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D., MPH
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
7728
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1083819
—
WA
01
—
232258
MEDICAL TRAINING/LIMITED LICENSE
MA
01
—
246201
MEDICAL LICENSE
MA
01
—
6810
MEDICAL LICENSE - TEMP
AK
01
—
7728
MEDICAL LICENS
AK
01
—
MD00372
ALASKA MEDICAID PROVIDER NUMBER
AK
01
—
MD60212882
MEDICAL LICENSE
WA
Enumeration date
06/15/2007
Last updated
05/20/2026
Update your record
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