Provider Demographics
NPI:1255497863
Name:COLMAN, ROBERT AUSTIN (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:AUSTIN
Last Name:COLMAN
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 1:1212 PLEASANT ST
Mailing Address - Street 2:SUITE 110
Mailing Address - City:DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50309-1410
Mailing Address - Country:US
Mailing Address - Phone:515-244-7229
Mailing Address - Fax:
Practice Address - Street 1:1212 PLEASANT ST
Practice Address - Street 2:SUITE 110
Practice Address - City:DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50309-1410
Practice Address - Country:US
Practice Address - Phone:515-244-7229
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA27299207KA0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207KA0200XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyAllergy
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0085225Medicaid
IA08218Medicare ID - Type Unspecified
IAF27601Medicare UPIN