Provider Demographics
NPI:1770352379
Name:COHEN, BERNARD MARTIN (MD)
Entity type:Individual
Prefix:DR
First Name:BERNARD
Middle Name:MARTIN
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 1:2730 VAN CLIBURN CIR
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:DE
Mailing Address - Zip Code:19709-3201
Mailing Address - Country:US
Mailing Address - Phone:770-862-4930
Mailing Address - Fax:
Practice Address - Street 1:2730 VAN CLIBURN CIR
Practice Address - Street 2:
Practice Address - City:MIDDLETOWN
Practice Address - State:DE
Practice Address - Zip Code:19709-3201
Practice Address - Country:US
Practice Address - Phone:770-862-4930
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-22
Last Update Date:2023-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME43906207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine