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NPI Code Detail

MEDICARE: MICHELLE RENEE COLEMAN RD

MEDICARE: MICHELLE RENEE COLEMAN RD
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
1133V00000XRegistered Dietitian932869PA

General Provider Information

NPI Number : 1417028127
Entity Type Code : Individual
Provider Name (Legal Business Name) : MICHELLE RENEE COLEMAN RD
Provider Business Mailing Address
First Line : 206 S ELMWOOD AVE
Second Line :
City : BUFFALO
State : NY
Zip : 14201-2398
Country : US
Telephone Number : 716-847-0328
Fax Number : 716-847-2715
Provider Business Practice Location Address
First Line : 206 S ELMWOOD AVE
Second Line :
City : BUFFALO
State : NY
Zip : 14201-2398
Country : US
Telephone Number : 716-847-0328
Fax Number : 716-847-2715
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/13/2006
Last Update Date : 07/08/2007

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Directions to “ MICHELLE RENEE COLEMAN RD” Practice Location

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