Individual
JOHN COULSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
600 N WOLFE ST, BALTIMORE, MD 21287-0005
(410) 614-4445
Mailing address
PO BOX 64316, BALTIMORE, MD 21264-4316
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
37342
IA
2080P0202X
Pediatric Cardiology Physician
37342
IA
2080P0202X
Pediatric Cardiology Physician
Primary
D68082
MD
2080P0202X
Pediatric Cardiology Physician
G29399
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
55962
WELLMARK BCBS
IA
Enumeration date
07/21/2006
Last updated
10/27/2008
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