Provider Demographics
NPI:1659377877
Name:COHEN, DAVID (DPM)
Entity Type:Individual
Prefix:MR
First Name:DAVID
Middle Name:
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 1:9403 HARFORD RD
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21234-3123
Mailing Address - Country:US
Mailing Address - Phone:410-882-5400
Mailing Address - Fax:410-882-5977
Practice Address - Street 1:9403 HARFORD RD
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21234-3123
Practice Address - Country:US
Practice Address - Phone:410-882-5400
Practice Address - Fax:410-882-5977
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-22
Last Update Date:2024-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD00385213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDT021OtherCAREFIRST
MDE4210001OtherBLUE CHOICE
MD480923980OtherRAILROAD MEDICARE
MDE4210001OtherFEDERAL CAREFIRST
MD600858500Medicaid
0995090001Medicare NSC
MDT021OtherCAREFIRST
MD600858500Medicaid