Healthcare Provider Details

I. General information

NPI: 1740254994
Provider Name (Legal Business Name): ROBERT G COATES MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/15/2006
Last Update Date: 04/30/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 WESCOTT DR STE 102
FLEMINGTON NJ
08822-4655
US

IV. Provider business mailing address

2100 WESCOTT DR
FLEMINGTON NJ
08822-4603
US

V. Phone/Fax

Practice location:
  • Phone: 908-237-1148
  • Fax: 908-237-1318
Mailing address:
  • Phone: 908-788-6100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number25MA03909900
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: