Provider Demographics
NPI:1003816729
Name:COHEN, LOREN H (MD)
Entity Type:Individual
Prefix:
First Name:LOREN
Middle Name:H
Last Name:COHEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4750 E GALBRAITH RD STE 103
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45236-6706
Mailing Address - Country:US
Mailing Address - Phone:513-791-2137
Mailing Address - Fax:513-791-2151
Practice Address - Street 1:4750 E GALBRAITH RD STE 103
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45236-6706
Practice Address - Country:US
Practice Address - Phone:513-791-2137
Practice Address - Fax:513-791-2151
Is Sole Proprietor?:No
Enumeration Date:2005-07-22
Last Update Date:2015-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35044778207RN0300X
IN01075254A207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH000000017865OtherANTHEM
IN200938020Medicaid
KY6486903500Medicaid
OH0437325Medicaid
OH0487726Medicare PIN
OHH046860Medicare PIN
OH000000017865OtherANTHEM
IN200938020Medicaid