Healthcare Provider Details

I. General information

NPI: 1538137492
Provider Name (Legal Business Name): RACHAEL ANNETTE COLEMAN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/08/2006
Last Update Date: 11/09/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

199 WILLIAM HOWARD TAFT RD
CINCINNATI OH
45219-2103
US

IV. Provider business mailing address

PO BOX 40183
CINCINNATI OH
45240-0183
US

V. Phone/Fax

Practice location:
  • Phone: 513-616-8774
  • Fax:
Mailing address:
  • Phone: 513-519-0366
  • Fax: 513-825-3919

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number35-07-6827
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code207RA0401X
TaxonomyAddiction Medicine (Internal Medicine) Physician
License Number35076827
License Number StateOH
# 3
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number35-07-6827
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: