Provider Demographics
NPI:1386906873
Name:COLEMAN, LEON GARLAND JR (MD)
Entity type:Individual
Prefix:
First Name:LEON
Middle Name:GARLAND
Last Name:COLEMAN
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 MANNING DR
Mailing Address - Street 2:DEPT OF SURGERY BURNETT-WOMACK BLDG, CB #7050
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27514-4220
Mailing Address - Country:US
Mailing Address - Phone:919-966-4653
Mailing Address - Fax:919-966-7841
Practice Address - Street 1:101 MANNING DR
Practice Address - Street 2:DEPT OF SURGERY BURNETT-WOMACK BLDG, CB #7050
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27514-4220
Practice Address - Country:US
Practice Address - Phone:919-966-4653
Practice Address - Fax:919-966-7841
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-12
Last Update Date:2012-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC182420390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program