Provider Demographics
NPI:1245251685
Name:COHEN, DAVID AHRON (MD)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:AHRON
Last Name:COHEN
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 1:1050 SOUTH NORTH POINT RD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21224
Mailing Address - Country:US
Mailing Address - Phone:410-282-7600
Mailing Address - Fax:410-282-4802
Practice Address - Street 1:1050 SOUTH NORTH POINT RD
Practice Address - Street 2:SUITE 101
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21224
Practice Address - Country:US
Practice Address - Phone:410-282-7600
Practice Address - Fax:410-282-4802
Is Sole Proprietor?:No
Enumeration Date:2006-07-21
Last Update Date:2009-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101241664207XX0005X
MDM68165207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
No207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV3810009116OtherWEST VIRGINIA MEDICAID
VA605040OtherSOUTHERN HEALTH
VA303117OtherANTHEM
VA7135127OtherCIGNA
VA1245251685Medicaid
WV3810009116OtherWEST VIRGINIA MEDICAID