Provider Demographics
NPI:1376502468
Name:COLEMAN, WENDY S (MD)
Entity type:Individual
Prefix:
First Name:WENDY
Middle Name:S
Last Name:COLEMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2115 CHADBOURNE AVE
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53726-3927
Mailing Address - Country:US
Mailing Address - Phone:608-238-9258
Mailing Address - Fax:
Practice Address - Street 1:2115 CHADBOURNE AVE
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53726-3927
Practice Address - Country:US
Practice Address - Phone:608-238-9258
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-03-20
Last Update Date:2022-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI19403208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics