| J. Thaddeus Coin, Phd, Md, Pllc | |
|
2515 Delaney Ave Wilmington NC 28403-6003 | |
| (910) 762-9131 | |
| (910) 762-1281 |
| Full Name | J. Thaddeus Coin, Phd, Md, Pllc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 2515 Delaney Ave, Wilmington, North Carolina |
| Authorized Official Name and Position | James Thaddeus Coin (OWNER) |
| Authorized Official Contact | 9107629131 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| J. Thaddeus Coin, Phd, Md, Pllc Po Box 3098 Wilmington NC 28406-0098 Ph: (910) 762-9131 | J. Thaddeus Coin, Phd, Md, Pllc 2515 Delaney Ave Wilmington NC 28403-6003 Ph: (910) 762-9131 |
| NPI Number | 1053465104 |
|---|---|
| Provider Enumeration Date | 01/23/2007 |
| Last Update Date | 05/10/2012 |
| Medicare PECOS PAC ID | 6002880770 |
|---|---|
| Medicare Enrollment ID | O20081020000058 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053465104 | NPI | - | NPPES |
| 23534 | Other | NC | BCBS |
| 7923534 | Medicaid | NC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | 29814 (North Carolina) | Primary |
| Provider Name | James Thaddeus Coin |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1124176664 PECOS PAC ID: 3274507942 Enrollment ID: I20040820000630 |
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