Healthcare Provider Details

I. General information

NPI: 1053702886
Provider Name (Legal Business Name): DAVID COLEMAN MA, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/16/2015
Last Update Date: 07/10/2026
Certification Date: 07/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3102 CAMP RANGER LN
JAMESTOWN NC
27282-8686
US

IV. Provider business mailing address

5710 W GATE CITY BLVD SUITE K #115
GREENSBORO NC
27407-7047
US

V. Phone/Fax

Practice location:
  • Phone: 336-706-0329
  • Fax:
Mailing address:
  • Phone: 336-706-0329
  • Fax: 877-840-0337

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number964
License Number StateNC

VIII. Authorized Official

Name: DAVID COLEMAN
Title or Position: PRESIDENT
Credential:
Phone: 336-706-0329