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Individual

DEWITT MCINTYRE COLEMAN JR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M. D.

Contact information

Practice address
103 MIDLANDS CT, WEST COLUMBIA, SC 29169-3456
(803) 794-3581
(803) 791-7286
Mailing address
PO BOX 603725, CHARLOTTE, NC 28260-3725
(828) 575-2625
(828) 350-2174

Taxonomy

Speciality
Code
Description
License number
State
207K00000X
Allergy & Immunology Physician
Primary
27671
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
276711
SC
01
AA08816874
MEDICARE PTAN
SC
Enumeration date
10/26/2005
Last updated
10/31/2023
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