Provider Demographics
NPI:1740261338
Name:COATES, TAMARA ELMIRA (MD)
Entity type:Individual
Prefix:
First Name:TAMARA
Middle Name:ELMIRA
Last Name:COATES
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:8110 MAPLE LAWN BLVD
Mailing Address - Street 2:STE 235
Mailing Address - City:FULTON
Mailing Address - State:MD
Mailing Address - Zip Code:20759-2694
Mailing Address - Country:US
Mailing Address - Phone:301-340-8339
Mailing Address - Fax:301-340-9027
Practice Address - Street 1:1400 FOREST GLEN RD
Practice Address - Street 2:STE 525
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20910-1459
Practice Address - Country:US
Practice Address - Phone:301-593-8101
Practice Address - Fax:301-593-1537
Is Sole Proprietor?:No
Enumeration Date:2005-11-10
Last Update Date:2023-09-21
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Provider Licenses
StateLicense IDTaxonomies
MDD0043696207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD532510200Medicaid
MDG04095Medicare UPIN
MD532510200Medicaid