Individual
MICHAEL S COLEMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.A.
Contact information
Practice address
1000 JOHNSON FERRY RD NE, ATLANTA, GA 30342-1606
(404) 303-3910
Mailing address
1000 JOHNSON FERRY RD NE, ATLANTA, GA 30342-1606
(404) 303-3910
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
004854
GA
363AM0700X
Medical Physician Assistant
PA04354
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01050710
AMERIGROUP
GA
05
—
194202142C
—
GA
05
—
194202142D
—
GA
01
—
346495
WELLCARE
GA
01
—
8N8242
BCBS
TX
Enumeration date
07/03/2006
Last updated
12/19/2008
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