MEDICARE: DAVID C. COFFEY MD

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	35063696	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1528063690
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAVID C. COFFEY MD

Provider Business Mailing Address
First Line	:	400 TECHNE CENTER DR
Second Line	:	STE 402
City	:	MILFORD
State	:	OH
Zip	:	45150-3708
Country	:	US
Telephone Number	:	513-576-7700
Fax Number	:	513-576-1020

Provider Business Practice Location Address
First Line	:	400 TECHNE CENTER DR
Second Line	:	STE 402
City	:	MILFORD
State	:	OH
Zip	:	45150-3708
Country	:	US
Telephone Number	:	513-576-7700
Fax Number	:	513-576-1020

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

Provider Enumeration Date	:	06/16/2005
Last Update Date	:	07/08/2007

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