Provider Demographics
NPI:1073501730
Name:COELUS, EILEEN (MD)
Entity Type:Individual
Prefix:
First Name:EILEEN
Middle Name:
Last Name:COELUS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:100 WALTER WARD BLVD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:ABINGDON
Mailing Address - State:MD
Mailing Address - Zip Code:21009-1285
Mailing Address - Country:US
Mailing Address - Phone:443-512-8484
Mailing Address - Fax:443-512-8488
Practice Address - Street 1:100 WALTER WARD BLVD
Practice Address - Street 2:SUITE 200
Practice Address - City:ABINGDON
Practice Address - State:MD
Practice Address - Zip Code:21009-1285
Practice Address - Country:US
Practice Address - Phone:443-512-8484
Practice Address - Fax:443-512-8488
Is Sole Proprietor?:No
Enumeration Date:2005-10-07
Last Update Date:2008-08-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MDD39140207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD827L049EMedicare PIN
MDF39375Medicare UPIN