Individual
DR. HARRY MARIO COLETTA II
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
106 E 8TH ST, WALNUT COVE, NC 27052-9399
(336) 591-7205
(336) 591-5114
Mailing address
PO BOX 678, WALNUT COVE, NC 27052-0678
(336) 591-7205
(336) 591-5114
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
24054
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
121
PARTNERS MCR CHOICE
NC
01
—
23756
BSBS
NC
05
—
8923756
—
NC
Enumeration date
06/28/2005
Last updated
07/08/2007
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