Basic Information
| Provider Information | |||||||||
| NPI: | 1235129487 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | COATES | ||||||||
| FirstName: | KEVIN | ||||||||
| MiddleName: | EMERSON | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 602658 | ||||||||
| Address2: | |||||||||
| City: | CHARLOTTE | ||||||||
| State: | NC | ||||||||
| PostalCode: | 282602658 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3367162011 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 131 MILLER ST | ||||||||
| Address2: | |||||||||
| City: | WINSTON SALEM | ||||||||
| State: | NC | ||||||||
| PostalCode: | 271032508 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3367168093 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/27/2005 | ||||||||
| LastUpdateDate: | 09/19/2016 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207X00000X | MD426809 | PA | N | Allopathic & Osteopathic Physicians | Orthopaedic Surgery | 207X00000X | 0101243787 | VA | N | Allopathic & Osteopathic Physicians | Orthopaedic Surgery | 207X00000X | MD049632 | TN | N | Allopathic & Osteopathic Physicians | Orthopaedic Surgery | 207XX0005X | 2011-01365 | NC | Y | Allopathic & Osteopathic Physicians | Orthopaedic Surgery | Sports Medicine | 207X00000X | 2011-01365 | NC | N | Allopathic & Osteopathic Physicians | Orthopaedic Surgery |
No ID Information.