Provider Demographics
NPI:1275526683
Name:COALSON, BARRY EDWARD (MD)
Entity Type:Individual
Prefix:
First Name:BARRY
Middle Name:EDWARD
Last Name:COALSON
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 1:711 N DEKALB ST
Mailing Address - Street 2:
Mailing Address - City:SHELBY
Mailing Address - State:NC
Mailing Address - Zip Code:28150-3911
Mailing Address - Country:US
Mailing Address - Phone:704-482-1482
Mailing Address - Fax:704-480-6012
Practice Address - Street 1:711 N DEKALB ST
Practice Address - Street 2:
Practice Address - City:SHELBY
Practice Address - State:NC
Practice Address - Zip Code:28150-3911
Practice Address - Country:US
Practice Address - Phone:704-482-1482
Practice Address - Fax:704-480-6012
Is Sole Proprietor?:No
Enumeration Date:2005-08-31
Last Update Date:2011-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC09901149207RP1001X
NC009901149207RC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC891246JMedicaid
NC891246JMedicaid
227832Medicare ID - Type Unspecified