Healthcare Provider Details

I. General information

NPI: 1558396606
Provider Name (Legal Business Name): DAVID B COLEMAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/11/2006
Last Update Date: 03/20/2025
Certification Date: 03/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16 US HIGHWAY 206
STANHOPE NJ
07874-3270
US

IV. Provider business mailing address

16 US HIGHWAY 206 APT 6
STANHOPE NJ
07874-3270
US

V. Phone/Fax

Practice location:
  • Phone: 908-852-3301
  • Fax:
Mailing address:
  • Phone: 908-852-3301
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2086S0129X
TaxonomyVascular Surgery Physician
License Number14159
License Number StateNH
# 2
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number229041
License Number StateMA
# 3
Primary TaxonomyN
Taxonomy Code2086S0129X
TaxonomyVascular Surgery Physician
License Number226016
License Number StateNY
# 4
Primary TaxonomyN
Taxonomy Code2086S0129X
TaxonomyVascular Surgery Physician
License Number25MA12578300
License Number StateNJ
# 5
Primary TaxonomyN
Taxonomy Code2086S0129X
TaxonomyVascular Surgery Physician
License Number52620
License Number StateKY
# 6
Primary TaxonomyN
Taxonomy Code2086S0129X
TaxonomyVascular Surgery Physician
License NumberMD456855
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: