Provider Demographics
NPI:1558396606
Name:COLEMAN, DAVID B (MD)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:B
Last Name:COLEMAN
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16 US HIGHWAY 206 APT 6
Mailing Address - Street 2:
Mailing Address - City:STANHOPE
Mailing Address - State:NJ
Mailing Address - Zip Code:07874-3270
Mailing Address - Country:US
Mailing Address - Phone:908-852-3301
Mailing Address - Fax:
Practice Address - Street 1:16 US HIGHWAY 206
Practice Address - Street 2:
Practice Address - City:STANHOPE
Practice Address - State:NJ
Practice Address - Zip Code:07874-3270
Practice Address - Country:US
Practice Address - Phone:908-852-3301
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-11
Last Update Date:2025-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH141592086S0129X
MA229041208600000X
NY2260162086S0129X
NJ25MA125783002086S0129X
KY526202086S0129X
PAMD4568552086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
No208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH3078724Medicaid
NHP01676822OtherRAILROAD MEDICARE
NHT400303387Medicare PIN