Provider Demographics
NPI:1245244631
Name:COLEMAN, THOMAS HEWITT (MD)
Entity Type:Individual
Prefix:
First Name:THOMAS
Middle Name:HEWITT
Last Name:COLEMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3555 OLENTANGY RIVER ROAD
Mailing Address - Street 2:SUITE #3090
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43214-3911
Mailing Address - Country:US
Mailing Address - Phone:614-267-9263
Mailing Address - Fax:614-267-2755
Practice Address - Street 1:3555 OLENTANGY RIVER ROAD
Practice Address - Street 2:SUITE #3090
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43214-3911
Practice Address - Country:US
Practice Address - Phone:614-267-9263
Practice Address - Fax:614-267-2755
Is Sole Proprietor?:No
Enumeration Date:2006-07-28
Last Update Date:2011-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35035513207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0478915Medicaid
OH0478915Medicaid
A80123Medicare UPIN