MEDICARE: G. ABRAMS AND R. COHEN XXI PC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry

General Provider Information

NPI Number	:	1447993399
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	G. ABRAMS AND R. COHEN XXI PC

Provider Business Mailing Address
First Line	:	2041 SOUTH BLVD STE C-2
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28203-5062
Country	:	US
Telephone Number	:	704-916-9970
Fax Number	:

Provider Business Practice Location Address
First Line	:	2041 SOUTH BLVD STE C-2
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28203-5062
Country	:	US
Telephone Number	:	704-246-8971
Fax Number	:

Authorized Official
Title or Position	:	COO
Name	:	JEFF COHEN
Credential	:
Telephone Number	:	704-246-8971

Provider Enumeration Date	:	04/19/2022
Last Update Date	:	09/13/2022

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