Provider Demographics
NPI:1558354183
Name:COHN, JEFFREY A (MD)
Entity Type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:A
Last Name:COHN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 37174
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21297-3174
Mailing Address - Country:US
Mailing Address - Phone:571-423-5699
Mailing Address - Fax:703-726-6444
Practice Address - Street 1:20905 PROFESSIONAL PLZ
Practice Address - Street 2:STE 330
Practice Address - City:ASHBURN
Practice Address - State:VA
Practice Address - Zip Code:20147-7783
Practice Address - Country:US
Practice Address - Phone:703-726-0003
Practice Address - Fax:703-726-6444
Is Sole Proprietor?:No
Enumeration Date:2005-08-30
Last Update Date:2023-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101231268207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA05647088Medicaid
VAP00010205OtherRR MEDICARE
VA003921F07Medicare PIN
VAP00010205OtherRR MEDICARE
H54869Medicare UPIN