Provider Demographics
NPI:1558459347
Name:COATES, STEVEN R (PA-C)
Entity type:Individual
Prefix:
First Name:STEVEN
Middle Name:R
Last Name:COATES
Suffix:
Gender:
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:181 FRANKLIN HEALTH CMNS
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON
Mailing Address - State:ME
Mailing Address - Zip Code:04938-6144
Mailing Address - Country:US
Mailing Address - Phone:207-778-9001
Mailing Address - Fax:207-779-2902
Practice Address - Street 1:181 FRANKLIN HEALTH CMNS
Practice Address - Street 2:
Practice Address - City:FARMINGTON
Practice Address - State:ME
Practice Address - Zip Code:04938-6144
Practice Address - Country:US
Practice Address - Phone:207-778-9001
Practice Address - Fax:207-779-2902
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-10
Last Update Date:2025-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEPA1511363AS0400X, 363A00000X
FLPA9101763363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1050992OtherP.A.CERTIFICATE NUMBER
FL291927300Medicaid
FLPA9101763OtherP.A.LICENSE NUMBER
FL970030726OtherRR MEDICARE PROVIDER NUMB
FL291927300Medicaid