Healthcare Provider Details

I. General information

NPI: 1407730823
Provider Name (Legal Business Name): DANIEL B COLEMAN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/31/2025
Last Update Date: 07/31/2025
Certification Date: 07/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

BLDG 626
APO AP
96367-0037
US

IV. Provider business mailing address

PSC 80 BOX 13403
APO AP
96367-0037
US

V. Phone/Fax

Practice location:
  • Phone: 544-630-4537
  • Fax:
Mailing address:
  • Phone: 806-281-3440
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code146L00000X
TaxonomyParamedic
License NumberM5077336
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: