Provider Demographics
NPI:1932100369
Name:COLMAN, MICHAEL D (MD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:D
Last Name:COLMAN
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 1:4550 QUARTON RD
Mailing Address - Street 2:
Mailing Address - City:BLOOMFIELD HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48302-2651
Mailing Address - Country:US
Mailing Address - Phone:248-862-2273
Mailing Address - Fax:248-862-2724
Practice Address - Street 1:4550 QUARTON RD
Practice Address - Street 2:
Practice Address - City:BLOOMFIELD HILLS
Practice Address - State:MI
Practice Address - Zip Code:48302-2651
Practice Address - Country:US
Practice Address - Phone:248-862-2273
Practice Address - Fax:248-862-2724
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-09
Last Update Date:2023-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI43010-28241103TC0700X, 103TC2200X, 103TF0000X, 103TP0814X, 102L00000X
MI4301028241102L00000X
MI43010-28242103TA0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes102L00000XBehavioral Health & Social Service ProvidersPsychoanalystGroup - Single Specialty
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent
No103TF0000XBehavioral Health & Social Service ProvidersPsychologistFamily
No103TP0814XBehavioral Health & Social Service ProvidersPsychologistPsychoanalysis
No103TA0700XBehavioral Health & Social Service ProvidersPsychologistAdult Development & Aging
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0630730Medicare ID - Type UnspecifiedMEDICARE NUMBER
MIF04375Medicare UPIN