Provider Demographics
NPI:1093731978
Name:COHEN, ALAN R (MD)
Entity Type:Individual
Prefix:
First Name:ALAN
Middle Name:R
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 1:3605 WARRENSVILLE CENTER RD
Mailing Address - Street 2:1ST FLOOR
Mailing Address - City:SHAKER HTS
Mailing Address - State:OH
Mailing Address - Zip Code:44122-5203
Mailing Address - Country:US
Mailing Address - Phone:216-286-6260
Mailing Address - Fax:216-286-6341
Practice Address - Street 1:11100 EUCLID AVE
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44106-1716
Practice Address - Country:US
Practice Address - Phone:216-844-3004
Practice Address - Fax:440-449-1555
Is Sole Proprietor?:No
Enumeration Date:2006-07-14
Last Update Date:2008-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-066882207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH363436OtherWELLCARE MEDICAID
OHP00412309OtherRAILROAD MEDICARE
OH0995455Medicaid
OH4125736OtherAETNA
OH0995455OtherBCMH
OH732534OtherBUCKEYE MEDICAID
OH000000523185OtherANTHEM
OH58425367OtherTRICARE
OH000000130222OtherANTHEM
OH000000218487OtherUNISON
OHB97601Medicare UPIN
OHCO0766381Medicare PIN
OHC00766384Medicare PIN