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General NPI Number Information
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NPI Number | 1841292778
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Entity Type | Individual
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Provider Name | STEPHEN ANDREW COULSON M.D.
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Gender | Male
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Dates
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Enumeration Date | 08/11/2005
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Last Update Date | 08/19/2025
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Provider Practice Location Address
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Address Line | 13400 N MERIDIAN ST STE 302
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City | CARMEL
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State | IN
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Zip | 46032-7104
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Country | US
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Telephone | 317-415-6050
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Fax | 317-415-6060
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Provider Business Mailing Address
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Address Line | 1115 MARGATE LN
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City | LIBERTYVILLE
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State | IL
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Zip | 60048-2441
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Country | US
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Telephone | 847-910-2850
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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 | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 036-098320
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 036-098320
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License Number State | IL
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Taxonomy #3
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Taxonomy Code | 207RA0401X
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Taxonomy Name | Addiction Medicine (Internal Medicine) Physician
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License Number | 036-098320
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License Number State | IL
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Taxonomy #4
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Taxonomy Code | 207RC0200X
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Taxonomy Name | Critical Care Medicine (Internal Medicine) Physician
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License Number | 036-098320
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License Number State | IL
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Taxonomy #5
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 01091281A
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License Number State | IN
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