Individual
MAKAYLA MARIE COAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
600 N WOLFE ST, BALTIMORE, MD 21287-0005
(410) 502-2651
Mailing address
6201 GREENLEIGH AVE, MIDDLE RIVER, MD 21220-2004
(410) 933-6423
(410) 500-4266
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
10004237A
IN
363A00000X
Physician Assistant
Primary
C0008517
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
C0008517
NON-MEDICARE/SELF PAY
MD
Enumeration date
07/13/2022
Last updated
09/20/2024
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