Healthcare Provider Details

I. General information

NPI: 1053342980
Provider Name (Legal Business Name): MARC A COLMAN BC HIS, ACA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/06/2006
Last Update Date: 09/26/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6307 S DIXIE HWY
WEST PALM BEACH FL
33405-4328
US

IV. Provider business mailing address

6307 S DIXIE HWY
WEST PALM BEACH FL
33405-4328
US

V. Phone/Fax

Practice location:
  • Phone: 561-585-5499
  • Fax: 561-585-5497
Mailing address:
  • Phone: 561-585-5499
  • Fax: 561-585-5497

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License NumberAS1782
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code246Z00000X
TaxonomyOther Specialist/Technologist
License NumberAS1782
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: