Provider Demographics
NPI:1912345562
Name:COLEY, TAREN (MD)
Entity Type:Individual
Prefix:
First Name:TAREN
Middle Name:
Last Name:COLEY
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 1:16621 DOVES CANYON LN
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28278-8111
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:101 MANNING DR
Practice Address - Street 2:DEPARTMENT OF PSYCHIATRY, CB#7160
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27599
Practice Address - Country:US
Practice Address - Phone:919-966-4764
Practice Address - Fax:919-966-9646
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-05
Last Update Date:2018-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC191437390200000X
NC2014-022872084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program