Coleman, Michael Wallace
Coleman, Michael Wallace is an sole proprietor health care provider with primary practice located at 2005 Highway 82 W , Greenwood MS 38930-2720. He recently has only one registered license in Allopathic & Osteopathic Physicians / Ophthalmology, which is considered as his primary health care specialty. Coleman, Michael Wallace can be contacted via phone (662) 455-4523.Contact Information
Primary practice address
2005 Highway 82 W
Greenwood MS 38930-2720
Phone: (662) 455-4523
Fax: (662) 455-3790
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Ophthalmology | 207W00000X | 06711 | Mississippi |
Profile Details
| NPI number | 1447258694 |
|---|---|
| LBN Legal business name | Coleman, Michael Wallace |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jul 12th, 2005 |
| Last updated | Apr 7th, 2010 - about 15 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1447258694 | NPPES |
| Mississippi | Other | 180041706 | R/R MEDICARE |
| Mississippi | MEDICAID | 00124307 | R/R MEDICARE |
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