Provider Demographics
NPI:1568057750
Name:COE, MICHAEL D II (AGNP)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:D
Last Name:COE
Suffix:II
Gender:M
Credentials:AGNP
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Mailing Address - Street 1:804 SERVICE RD STE A109B
Mailing Address - Street 2:
Mailing Address - City:EAST LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48824-7015
Mailing Address - Country:US
Mailing Address - Phone:517-364-5260
Mailing Address - Fax:517-364-5251
Practice Address - Street 1:1200 E MICHIGAN AVE STE 520
Practice Address - Street 2:
Practice Address - City:LANSING
Practice Address - State:MI
Practice Address - Zip Code:48912-1899
Practice Address - Country:US
Practice Address - Phone:517-364-5260
Practice Address - Fax:517-364-5251
Is Sole Proprietor?:No
Enumeration Date:2021-03-09
Last Update Date:2023-06-27
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Provider Licenses
StateLicense IDTaxonomies
MI4704277638208100000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation