Provider Demographics
NPI:1770575326
Name:COHEN, HOWARD BYRON (MD)
Entity type:Individual
Prefix:DR
First Name:HOWARD
Middle Name:BYRON
Last Name:COHEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:6717 PARK HEIGHTS AVE
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21215-2443
Mailing Address - Country:US
Mailing Address - Phone:410-764-6764
Mailing Address - Fax:410-363-1272
Practice Address - Street 1:6717 PARK HEIGHTS AVE
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21215-2443
Practice Address - Country:US
Practice Address - Phone:410-764-6764
Practice Address - Fax:410-363-1272
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-19
Last Update Date:2019-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD21680207RA0401X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RA0401XAllopathic & Osteopathic PhysiciansInternal MedicineAddiction Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD272901600Medicaid
D74578Medicare UPIN
MD272901600Medicaid