Provider Demographics
NPI:1396426045
Name:COHEN, MERRILL ALAN (MD)
Entity type:Individual
Prefix:
First Name:MERRILL
Middle Name:ALAN
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 1:4550 BULL RD LOT 12
Mailing Address - Street 2:
Mailing Address - City:DOVER
Mailing Address - State:PA
Mailing Address - Zip Code:17315-2011
Mailing Address - Country:US
Mailing Address - Phone:717-292-4804
Mailing Address - Fax:
Practice Address - Street 1:4550 BULL RD LOT 12
Practice Address - Street 2:
Practice Address - City:DOVER
Practice Address - State:PA
Practice Address - Zip Code:17315-2011
Practice Address - Country:US
Practice Address - Phone:717-292-4804
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-26
Last Update Date:2023-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD013971E207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine