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NPI Code Detail

MEDICARE: CEMIYAH COLEMAN

MEDICARE: CEMIYAH COLEMAN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1104100000XSocial Worker

General Provider Information

NPI Number : 1255293817
Entity Type Code : Individual
Provider Name (Legal Business Name) : CEMIYAH COLEMAN
Provider Business Mailing Address
First Line : 6309 MACK AVE
Second Line :
City : DETROIT
State : MI
Zip : 48207-2302
Country : US
Telephone Number : 313-921-4700
Fax Number :
Provider Business Practice Location Address
First Line : 6309 MACK AVE
Second Line :
City : DETROIT
State : MI
Zip : 48207-2302
Country : US
Telephone Number : 313-480-0838
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/02/2025
Last Update Date : 12/04/2025

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Directions to “ CEMIYAH COLEMAN ” Practice Location

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