Provider Demographics
NPI:1306832696
Name:COHEN, TODD DOUGLAS (MD)
Entity Type:Individual
Prefix:DR
First Name:TODD
Middle Name:DOUGLAS
Last Name:COHEN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:9735 KINCEY AVE
Mailing Address - Street 2:SUITE 201
Mailing Address - City:HUNTERSVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28078-9118
Mailing Address - Country:US
Mailing Address - Phone:704-414-2870
Mailing Address - Fax:704-414-2860
Practice Address - Street 1:12610 N COMMUNITY HOUSE RD STE 100
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28277-3892
Practice Address - Country:US
Practice Address - Phone:704-752-3730
Practice Address - Fax:704-752-9056
Is Sole Proprietor?:No
Enumeration Date:2005-09-22
Last Update Date:2018-10-03
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NC9500538208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCF47119Medicare UPIN