Provider Demographics
NPI:1033197561
Name:COULEMAN, NANCY R (MD)
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:R
Last Name:COULEMAN
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:11240 WAPLES MILL RD
Mailing Address - Street 2:SUITE 403
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22030-6078
Mailing Address - Country:US
Mailing Address - Phone:703-246-8080
Mailing Address - Fax:703-691-4932
Practice Address - Street 1:8501 ARLINGTON BLVD
Practice Address - Street 2:SUITE 550
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22031-4617
Practice Address - Country:US
Practice Address - Phone:703-573-2363
Practice Address - Fax:703-573-7609
Is Sole Proprietor?:No
Enumeration Date:2006-01-05
Last Update Date:2007-10-23
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
VA0101037490207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD145N104GMedicare PIN