Healthcare Provider Details

I. General information

NPI: 1871576264
Provider Name (Legal Business Name): LAKIMERLY MICHELLE COATES MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LAKIMERLY MICHELLE WOODS-COATES MD

II. Dates (important events)

Enumeration Date: 11/21/2005
Last Update Date: 07/10/2026
Certification Date: 07/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

165 SCOTT AVE STE 100
MORGANTOWN WV
26508-8847
US

IV. Provider business mailing address

PO BOX 746768
ATLANTA GA
30374-6768
US

V. Phone/Fax

Practice location:
  • Phone: 715-531-5650
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207ND0900X
TaxonomyDermatopathology Physician
License Number036102903
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code207ND0900X
TaxonomyDermatopathology Physician
License Number2026-02304
License Number StateNC
# 3
Primary TaxonomyN
Taxonomy Code207NS0135X
TaxonomyProcedural Dermatology Physician
License Number036102903
License Number StateIL
# 4
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number36829
License Number StateWV
# 5
Primary TaxonomyN
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License NumberC199443
License Number StateCA
# 6
Primary TaxonomyN
Taxonomy Code207ND0101X
TaxonomyMOHS-Micrographic Surgery Physician
License Number036102903
License Number StateIL
# 7
Primary TaxonomyN
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number036102903
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: