Provider Demographics
NPI:1558396606
Name:COLEMAN, DAVID B (MD)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:B
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 1:200 GRIFFIN RD
Mailing Address - Street 2:SUITE 6
Mailing Address - City:PORTSMOUTH
Mailing Address - State:NH
Mailing Address - Zip Code:03801-7145
Mailing Address - Country:US
Mailing Address - Phone:603-610-4430
Mailing Address - Fax:603-610-4432
Practice Address - Street 1:200 GRIFFIN RD
Practice Address - Street 2:SUITE 6
Practice Address - City:PORTSMOUTH
Practice Address - State:NH
Practice Address - Zip Code:03801-7145
Practice Address - Country:US
Practice Address - Phone:603-610-4430
Practice Address - Fax:603-610-4432
Is Sole Proprietor?:No
Enumeration Date:2006-07-11
Last Update Date:2021-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2260162086S0129X
MA229041208600000X
KY526202086S0129X
PAMD4568552086S0129X
NH141592086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
No208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH3078724Medicaid
NHP01676822OtherRAILROAD MEDICARE
NHT400303387Medicare PIN