Provider Demographics
NPI:1780638437
Name:COHEN, SETH (MD)
Entity Type:Individual
Prefix:
First Name:SETH
Middle Name:
Last Name:COHEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:15 MARKET CENTER DR STE A
Mailing Address - Street 2:
Mailing Address - City:FLAT ROCK
Mailing Address - State:NC
Mailing Address - Zip Code:28731-8529
Mailing Address - Country:US
Mailing Address - Phone:828-697-1170
Mailing Address - Fax:828-698-4939
Practice Address - Street 1:15 MARKET CENTER DR
Practice Address - Street 2:STE A
Practice Address - City:FLAT ROCK
Practice Address - State:NC
Practice Address - Zip Code:28731-8528
Practice Address - Country:US
Practice Address - Phone:828-697-1170
Practice Address - Fax:828-698-4939
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-19
Last Update Date:2019-01-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC33967207N00000X, 207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLE90410Medicaid
NC19BN3OtherBCBS NC
NCNCM396F459OtherMEDICARE
NCP01606740OtherRAILROAD MEDICARE