Provider Demographics
NPI:1952344533
Name:COHN, PETER S (MD)
Entity Type:Individual
Prefix:
First Name:PETER
Middle Name:S
Last Name:COHN
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 1:200 MILL RD
Mailing Address - Street 2:SUITE 180
Mailing Address - City:FAIRHAVEN
Mailing Address - State:MA
Mailing Address - Zip Code:02719-5252
Mailing Address - Country:US
Mailing Address - Phone:508-973-2000
Mailing Address - Fax:508-973-2001
Practice Address - Street 1:1030 PRESIDENT AVE
Practice Address - Street 2:SUITE 3001
Practice Address - City:FALL RIVER
Practice Address - State:MA
Practice Address - Zip Code:02720-5923
Practice Address - Country:US
Practice Address - Phone:508-973-9700
Practice Address - Fax:508-674-7378
Is Sole Proprietor?:No
Enumeration Date:2006-06-13
Last Update Date:2020-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA75377207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA3109976Medicaid
RIPC08426OtherEDS
MA060018861OtherRAILROAD MEDICARE
MA075377OtherTUFTS HEALTH PLAN
MAMA0014408OtherTRICARE
RI004673OtherBLUE CHIP
RI46361OtherRI BLUE SHIELD
MA534671OtherAETNA US HEALTHCARE
MA000000022173OtherBMC HEALTHNET PLAN
MA61641OtherHARVARD PILGRIM
MAJ13655OtherBLUE SHIELD
MA3109976Medicaid
RIPC08426OtherEDS
MA61641OtherHARVARD PILGRIM
MA3109976Medicaid