Individual
TYESHA MONIQUE COLEMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1120 15TH ST BLDG 1019, AUGUSTA, GA 30912-1101
(706) 721-3531
Mailing address
1120 15TH ST BLDG 1019, AUGUSTA, GA 30912-0006
(225) 270-9987
Taxonomy
Speciality
Code
Description
License number
State
207K00000X
Allergy & Immunology Physician
Primary
94849
GA
207R00000X
Internal Medicine Physician
Primary
94849
GA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/07/2020
Last updated
03/25/2026
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