Provider Demographics
NPI:1073593273
Name:COATES, ELIZABETH A (MD)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:A
Last Name:COATES
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:58 OLD NORTH RD
Mailing Address - Street 2:
Mailing Address - City:WORTHINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:01098-9753
Mailing Address - Country:US
Mailing Address - Phone:413-238-5511
Mailing Address - Fax:413-238-5358
Practice Address - Street 1:58 OLD NORTH RD
Practice Address - Street 2:
Practice Address - City:WORTHINGTON
Practice Address - State:MA
Practice Address - Zip Code:01098-9753
Practice Address - Country:US
Practice Address - Phone:413-238-5511
Practice Address - Fax:413-238-5358
Is Sole Proprietor?:No
Enumeration Date:2006-01-23
Last Update Date:2010-07-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA217064207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA04-2161484OtherPIONEER HEALTH NETWORK
MA1302469Medicaid
MA0030817OtherNEIGHORHOOD HEALTH PLAN
MA04-2161484OtherGREAT-WEST
MA04-2161484OtherCONSOLIDATED
MA04-2161484OtherUNICARE/GIC
MA33281OtherHEALTH NEW ENGLAND
MA3343555OtherAETNA
MAAA600OtherHARVARD PILGRIM
MA04-2161484OtherNORTHEAST HEALTH DIRECT
MA04-2161484OtherNORTH AMERICAN PREFERRED
MA1962714OtherCIGNA
MA217064OtherCONNECTICARE
MA467272OtherTUFTS
MA04-2161484OtherNORTHEAST HEALTHCARE ALLI
MA04-2161484OtherPLAN VISTA
MAJ26914OtherBCBS MA
MA467272OtherTUFTS
MA04-2161484OtherNORTHEAST HEALTHCARE ALLI