Provider Demographics
NPI:1326048745
Name:COBB, CHARLES FRANKLIN (MD)
Entity Type:Individual
Prefix:
First Name:CHARLES
Middle Name:FRANKLIN
Last Name:COBB
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 1:420 E NORTH AVE
Mailing Address - Street 2:SUITE 304 AGH SURGERY
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15212-4746
Mailing Address - Country:US
Mailing Address - Phone:412-359-4068
Mailing Address - Fax:412-359-6732
Practice Address - Street 1:420 E NORTH AVE
Practice Address - Street 2:SUITE 304 AGH SURGERY
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15212-4746
Practice Address - Country:US
Practice Address - Phone:412-359-4068
Practice Address - Fax:412-359-6732
Is Sole Proprietor?:No
Enumeration Date:2005-07-28
Last Update Date:2009-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD016511E208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0436719Medicaid
WV0045149000Medicaid
PA0006826350004Medicaid
PA152650NJ8Medicare PIN
PA0006826350004Medicaid
PAC32045Medicare UPIN