Provider Demographics
NPI:1124201660
Name:DAVID COHEN DPM, PA
Entity Type:Organization
Organization Name:DAVID COHEN DPM, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:COHEN
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:410-882-5400
Mailing Address - Street 1:9403 HARFORD RD
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21234-3123
Mailing Address - Country:US
Mailing Address - Phone:410-882-5400
Mailing Address - Fax:
Practice Address - Street 1:9403 HARFORD RD
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21234-3123
Practice Address - Country:US
Practice Address - Phone:410-882-5400
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-06
Last Update Date:2008-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD00384213ES0131X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD600858500Medicaid
MDT021OtherCAREFIRST
MD480923980OtherRAILROAD MEDICARE
MDE4210001OtherCAREFIRST FEDERAL
MDT59804Medicare UPIN
MDE4210001OtherCAREFIRST FEDERAL
MDT021Medicare PIN