Provider Demographics
NPI:1669471934
Name:COHAGAN, AMY (DO)
Entity Type:Individual
Prefix:DR
First Name:AMY
Middle Name:
Last Name:COHAGAN
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:595 COPELAND MILL RD
Mailing Address - Street 2:SUITE 1D
Mailing Address - City:WESTERVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43081-8908
Mailing Address - Country:US
Mailing Address - Phone:614-839-5222
Mailing Address - Fax:
Practice Address - Street 1:595 COPELAND MILL RD
Practice Address - Street 2:SUITE 1D
Practice Address - City:WESTERVILLE
Practice Address - State:OH
Practice Address - Zip Code:43081-8908
Practice Address - Country:US
Practice Address - Phone:614-839-5222
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-07-19
Last Update Date:2011-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH34-006685207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH000000191725OtherANTHEM
OH7656562OtherAETNA
OH2176809Medicaid
OH1910993OtherFIRST HEALTH
OH7656562OtherAETNA
OH1910993OtherFIRST HEALTH