Healthcare Provider Details

I. General information

NPI: 1073448965
Provider Name (Legal Business Name): TREVOR T COATES
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/15/2026
Last Update Date: 06/15/2026
Certification Date: 06/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10900 EUCLID AVE
CLEVELAND OH
44106-1712
US

IV. Provider business mailing address

5921 THERFIELD DR
SYLVANIA OH
43560-1038
US

V. Phone/Fax

Practice location:
  • Phone: 216-368-6459
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number514144
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: