MEDICARE: DR. JOSEPH COHEN

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	207RC0000X	Cardiovascular Disease Physician	2005-01871	NC

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
3	CO583849	OTHER	NC	MEDICARE ID

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	142HG	OTHER	NC	BCBS
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1700815206
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOSEPH COHEN

Provider Business Mailing Address
First Line	:	PO BOX 896206
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28289-6206
Country	:	US
Telephone Number	:	252-808-0145
Fax Number	:	252-808-2770

Provider Business Practice Location Address
First Line	:	4252 ARENDELL ST
Second Line	:	SUITE E
City	:	MOREHEAD CITY
State	:	NC
Zip	:	28557-2866
Country	:	US
Telephone Number	:	252-808-0145
Fax Number	:	252-808-2770

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/30/2006
Last Update Date	:	03/17/2017

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