Provider Demographics
NPI:1457344095
Name:COLEMAN, LINDA ELAINE (MD)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:ELAINE
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 1:224-D CORNWALL ST. NW SUITE 403
Mailing Address - Street 2:
Mailing Address - City:LEESBURG
Mailing Address - State:VA
Mailing Address - Zip Code:20176-2704
Mailing Address - Country:US
Mailing Address - Phone:703-737-6010
Mailing Address - Fax:703-443-8643
Practice Address - Street 1:2 PIDGEON HILL DRIVE, SUITE 400
Practice Address - Street 2:
Practice Address - City:STERLING
Practice Address - State:VA
Practice Address - Zip Code:20165-6129
Practice Address - Country:US
Practice Address - Phone:703-430-7090
Practice Address - Fax:703-444-9878
Is Sole Proprietor?:No
Enumeration Date:2005-08-30
Last Update Date:2022-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101041046207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
110204717OtherRR MEDICARE
VA1457344095Medicaid
E42418Medicare UPIN
VA05841518Medicaid