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NPI Code Detail

MEDICARE: KHALID AMIR COLEMAN

MEDICARE:   KHALID AMIR COLEMAN
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
1103K00000XBehavior Analyst

General Provider Information

NPI Number : 1952813685
Entity Type Code : Individual
Provider Name (Legal Business Name) : KHALID AMIR COLEMAN
Provider Business Mailing Address
First Line : 700 EVERETT ST APT 2025
Second Line :
City : RICHMOND
State : VA
Zip : 23224-4294
Country : US
Telephone Number : 804-484-2558
Fax Number :
Provider Business Practice Location Address
First Line : 5705 S LABURNUM AVE
Second Line :
City : RICHMOND
State : VA
Zip : 23231-4420
Country : US
Telephone Number : 804-737-3917
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/03/2017
Last Update Date : 11/03/2017

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Directions to “ KHALID AMIR COLEMAN ” Practice Location

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