Provider Demographics
NPI:1609817410
Name:DR. RICHARD COLMAN DO PLLC
Entity Type:Organization
Organization Name:DR. RICHARD COLMAN DO PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:
Authorized Official - Last Name:COLMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:586-759-3855
Mailing Address - Street 1:27500 HOOVER RD
Mailing Address - Street 2:
Mailing Address - City:WARREN
Mailing Address - State:MI
Mailing Address - Zip Code:48093-4586
Mailing Address - Country:US
Mailing Address - Phone:586-759-3855
Mailing Address - Fax:586-759-3860
Practice Address - Street 1:27500 HOOVER RD
Practice Address - Street 2:
Practice Address - City:WARREN
Practice Address - State:MI
Practice Address - Zip Code:48093-4586
Practice Address - Country:US
Practice Address - Phone:586-759-3855
Practice Address - Fax:586-759-3860
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-10
Last Update Date:2007-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5101006109207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1655011854OtherBCBS GROUP PIN
MIE26564Medicare UPIN
MI0P22820Medicare PIN