Healthcare Provider Details

I. General information

NPI: 1578583092
Provider Name (Legal Business Name): ISAIAS CLAUDIO COELHO MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/20/2006
Last Update Date: 02/08/2024
Certification Date: 02/08/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1035 RED BUD RD NE
CALHOUN GA
30701-6010
US

IV. Provider business mailing address

1035 RED BUD RD NE
CALHOUN GA
30701-6010
US

V. Phone/Fax

Practice location:
  • Phone: 706-602-7800
  • Fax:
Mailing address:
  • Phone: 66-027-8007
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberM-1736
License Number StateGU
# 2
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberA94599
License Number StateCA
# 3
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number79134
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: