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NPI Code Detail

MEDICARE: JUSTIN COATES

MEDICARE:   JUSTIN  COATES
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
11041C0700XClinical Social Worker6801109564MI

General Provider Information

NPI Number : 1275054330
Entity Type Code : Individual
Provider Name (Legal Business Name) : JUSTIN COATES
Provider Business Mailing Address
First Line : 11908 GRANT ST
Second Line :
City : RIVERVIEW
State : MI
Zip : 48193-4242
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 26184 OUTER DR
Second Line :
City : LINCOLN PARK
State : MI
Zip : 48146-2084
Country : US
Telephone Number : 313-389-7500
Fax Number : 248-299-0030
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/29/2017
Last Update Date : 05/12/2026

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Directions to “ JUSTIN COATES ” Practice Location

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