Provider Demographics
NPI:1326042128
Name:COHEN, CRAIG L (DPM)
Entity Type:Individual
Prefix:DR
First Name:CRAIG
Middle Name:L
Last Name:COHEN
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7211 SAWMILL ROAD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:DUBLIN
Mailing Address - State:OH
Mailing Address - Zip Code:43016-5008
Mailing Address - Country:US
Mailing Address - Phone:614-766-6556
Mailing Address - Fax:614-766-6556
Practice Address - Street 1:7211 SAWMILL ROAD
Practice Address - Street 2:SUITE 100
Practice Address - City:DUBLIN
Practice Address - State:OH
Practice Address - Zip Code:43016-5008
Practice Address - Country:US
Practice Address - Phone:614-766-6556
Practice Address - Fax:614-766-6556
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-09
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH36002049213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH000000118510OtherANTHEM
OH0473689Medicaid
OH31112256800OtherWORKMAN'S COMPENSATION
OH31112256800OtherWORKMAN'S COMPENSATION
OH000000118510OtherANTHEM