Provider Demographics
NPI:1811044282
Name:KOHRMAN, MICHAEL JOHN (MD)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:JOHN
Last Name:KOHRMAN
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 1:7802 DELTA WOODS DR
Mailing Address - Street 2:
Mailing Address - City:BAY MINETTE
Mailing Address - State:AL
Mailing Address - Zip Code:36507-8167
Mailing Address - Country:US
Mailing Address - Phone:251-626-0901
Mailing Address - Fax:251-626-0902
Practice Address - Street 1:26211 EQUITY DR
Practice Address - Street 2:SUITE A
Practice Address - City:DAPHNE
Practice Address - State:AL
Practice Address - Zip Code:36526-6189
Practice Address - Country:US
Practice Address - Phone:251-626-0901
Practice Address - Fax:251-626-0902
Is Sole Proprietor?:No
Enumeration Date:2007-01-05
Last Update Date:2014-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.0574022081P2900X
PAMD034146E2081P2900X
IN01052338A2081P2900X
FLME 1000562081P2900X
MOMD R8G18208100000X
ALMD.296172081P2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain Medicine
No208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH43145208700OtherOH WORKERS' COMP
AL51049505OtherBLUE CROSS BLUE SHIELD OF ALABAMA
OH000000033788OtherANTHEM PROVIDER NUMBER
OH0739106Medicaid
AL111544Medicaid
FL12519002OtherUNITED HEALTHCARE
OH4412474OtherAETNA PROVIDER NUMBER
FL16250OtherBLUE CROSS BLUE SHIELD OF FLORIDA
OH060005763OtherRAIL ROAD MEDICARE NUMBER
OH12519002OtherUNITED HEALTHCARE
FLME100056OtherFL WORKERS' COMP
AL51049505OtherBLUE CROSS BLUE SHIELD OF ALABAMA
FLBV248ZMedicare PIN
OH060005763OtherRAIL ROAD MEDICARE NUMBER
OH000000033788OtherANTHEM PROVIDER NUMBER
OH43145208700OtherOH WORKERS' COMP
OHKO0626911Medicare PIN
OHA10507Medicare UPIN
OHKO0626914Medicare PIN