Davidson, Coleman Wade

Davidson, Coleman Wade is an individual health care provider with primary practice located at 5301 E Grant Rd , Tucson AZ 85712-2805. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Obstetrics & Gynecology, Allopathic & Osteopathic Physicians / Obstetrics. Allopathic & Osteopathic Physicians / Obstetrics is his primary health care specialty. Davidson, Coleman Wade can be contacted via phone (520) 795-8188.

Contact Information

Primary practice address
5301 E Grant Rd Tucson AZ 85712-2805
Fax: (520) 325-0809
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Obstetrics & Gynecology 207V00000X 13613 Tennessee
Allopathic & Osteopathic Physicians / Obstetrics 207VX0000X 53209 Arizona

Profile Details

NPI number 1013910157
LBN Legal business name Davidson, Coleman Wade
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 23rd, 2005
Last updated Sep 13th, 2021 - about 3 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1013910157 NPPES
Arizona MEDICAID 254811
Arizona Other 53209

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