Provider Demographics
NPI:1407106628
Name:COLEMAN, TARA (PA-C)
Entity Type:Individual
Prefix:MS
First Name:TARA
Middle Name:
Last Name:COLEMAN
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:DUMC 3688 40 DUKE MEDICINE CIRCLE
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27710-0001
Mailing Address - Country:US
Mailing Address - Phone:919-668-7215
Mailing Address - Fax:919-684-0572
Practice Address - Street 1:40 DUKE MEDICINE CIR
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27710-4554
Practice Address - Country:US
Practice Address - Phone:919-668-7215
Practice Address - Fax:919-684-0572
Is Sole Proprietor?:No
Enumeration Date:2012-09-14
Last Update Date:2023-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC0010-03783363AM0700X, 363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical