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1801241104

NPI Code Detail

MEDICARE: DR. GEORGE CAMERON COLEMAN JR. MD

MEDICARE: DR. GEORGE CAMERON COLEMAN JR. 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	207R00000X	Internal Medicine Physician	217975	NC
2	2083P0901X	Public Health & General Preventive Medicine Physician	2017-02380	NC
3	2083A0300X	Addiction Medicine (Preventive Medicine) Physician	2017-02380	NC

General Provider Information

NPI Number	:	1801241104
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. GEORGE CAMERON COLEMAN JR. MD

Provider Business Mailing Address
First Line	:	4705 UNIVERSITY DR BLDG 700
Second Line	:
City	:	DURHAM
State	:	NC
Zip	:	27707-3489
Country	:	US
Telephone Number	:	919-237-1337
Fax Number	:	866-538-4716

Provider Business Practice Location Address
First Line	:	6118 SAINT GILES ST STE 130
Second Line	:
City	:	RALEIGH
State	:	NC
Zip	:	27612-7099
Country	:	US
Telephone Number	:	833-997-3806
Fax Number	:

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

Provider Enumeration Date	:	04/25/2016
Last Update Date	:	06/16/2025

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Directions to “ DR. GEORGE CAMERON COLEMAN JR. MD” Practice Location

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