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General NPI Number Information
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NPI Number | 1548077233
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Entity Type | Individual
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Provider Name | ISABELLA BUENCONSEJO COATS MD
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Gender | Female
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Dates
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Enumeration Date | 12/16/2024
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Last Update Date | 01/06/2026
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Provider Practice Location Address
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Address Line | 750 BROADWAY STE 350
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City | FORT WAYNE
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State | IN
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Zip | 46802-1412
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Country | US
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Telephone | 260-423-2675
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Fax | 260-969-2905
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Provider Business Mailing Address
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Address Line | 750 BROADWAY STE 250
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City | FORT WAYNE
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State | IN
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Zip | 46802-1412
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Country | US
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Telephone | 260-423-2675
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 11024498A
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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