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NPI Code Detail

MEDICARE: GEORGE GLENN COATES M.D.

MEDICARE: GEORGE GLENN COATES M.D.
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
12085B0100XBody Imaging Physician96-00489NC

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
164592OTHERNCMEDCOST
216-54591OTHERNCUNITED HEALTHCARE
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
416-54590OTHERNCUNITED HEALTHCARE
516-54592OTHERNCUNITED HEALTHCARE
664594OTHERNCMEDCOST
723212OTHERNCBLUECROSS BLUESHIELD
865491OTHERNCMEDCOST

General Provider Information

NPI Number : 1609833011
Entity Type Code : Individual
Provider Name (Legal Business Name) : GEORGE GLENN COATES M.D.
Provider Business Mailing Address
First Line : PO BOX 19368
Second Line :
City : RALEIGH
State : NC
Zip : 27619-9368
Country : US
Telephone Number : 919-787-8221
Fax Number : 919-789-4461
Provider Business Practice Location Address
First Line : 3949 BROWNING PL
Second Line :
City : RALEIGH
State : NC
Zip : 27609-6504
Country : US
Telephone Number : 919-787-8221
Fax Number : 919-789-4461
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/28/2006
Last Update Date : 07/08/2007

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