Provider Demographics
NPI:1255598736
Name:COAN, BRIAN STUART (MD)
Entity type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:STUART
Last Name:COAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:2001 WESTON PKWY
Mailing Address - Street 2:
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27513-5512
Mailing Address - Country:US
Mailing Address - Phone:919-484-4884
Mailing Address - Fax:919-484-1414
Practice Address - Street 1:2001 WESTON PKWY
Practice Address - Street 2:
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27513-5512
Practice Address - Country:US
Practice Address - Phone:919-484-4484
Practice Address - Fax:919-484-1414
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-21
Last Update Date:2020-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2008-010412086S0122X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC2023318OtherMEDICARE PTAN