Provider Demographics
NPI:1548226319
Name:COHEN, ROBERT MILES (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:MILES
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 1:107 COMMERCIAL STREET
Mailing Address - Street 2:
Mailing Address - City:MASHPEE
Mailing Address - State:MA
Mailing Address - Zip Code:02649-6507
Mailing Address - Country:US
Mailing Address - Phone:508-477-7090
Mailing Address - Fax:508-477-7028
Practice Address - Street 1:107 COMMERCIAL STREET
Practice Address - Street 2:COMMUNITY HEALTH CENTER OF CAPE COD, INC.
Practice Address - City:MASHPEE
Practice Address - State:MA
Practice Address - Zip Code:02649-6507
Practice Address - Country:US
Practice Address - Phone:508-477-7090
Practice Address - Fax:508-477-7028
Is Sole Proprietor?:No
Enumeration Date:2006-04-21
Last Update Date:2011-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT021541207R00000X
MA234625207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT004394532Medicaid
CTB37832Medicare UPIN
MAB37832Medicare UPIN
CT004394532Medicaid