Provider Demographics
NPI:1265656748
Name:COULTER, JAMES EDWARD (DO)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:EDWARD
Last Name:COULTER
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 1239
Mailing Address - Street 2:
Mailing Address - City:TROY
Mailing Address - State:MI
Mailing Address - Zip Code:48099-1239
Mailing Address - Country:US
Mailing Address - Phone:248-824-6600
Mailing Address - Fax:248-324-1477
Practice Address - Street 1:4623 WESLEY AVE
Practice Address - Street 2:SUITE P
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45212-2246
Practice Address - Country:US
Practice Address - Phone:513-841-0777
Practice Address - Fax:513-841-0877
Is Sole Proprietor?:No
Enumeration Date:2007-04-13
Last Update Date:2013-07-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OH34.006105207Q00000X, 207QA0505X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult Medicine