MEDICARE: DR. SHELLI I COLEMAN DO

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	21060	MS

General Provider Information

NPI Number	:	1194967349
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SHELLI I COLEMAN DO

Provider Business Mailing Address
First Line	:	350 N HUMPHREYS BLVD
Second Line	:
City	:	MEMPHIS
State	:	TN
Zip	:	38120-2177
Country	:	US
Telephone Number	:	901-226-4003
Fax Number	:	901-227-8591

Provider Business Practice Location Address
First Line	:	216 OXFORD RD
Second Line	:
City	:	NEW ALBANY
State	:	MS
Zip	:	38652-3115
Country	:	US
Telephone Number	:	662-534-9042
Fax Number	:	662-534-9707

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/02/2009
Last Update Date	:	04/15/2026

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