Healthcare Provider Details

I. General information

NPI: 1144310129
Provider Name (Legal Business Name): JOHN BRONER COHEN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/13/2006
Last Update Date: 09/22/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 PENNSYLVANIA AVE SE SUITE 202
WASHINGTON DC
20003-4316
US

IV. Provider business mailing address

600 PENNSYLVANIA AVE SE SUITE 202
WASHINGTON DC
20003-4316
US

V. Phone/Fax

Practice location:
  • Phone: 202-544-5858
  • Fax:
Mailing address:
  • Phone: 202-544-5858
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberMD11756
License Number StateDC
# 2
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberD0030901
License Number StateMD
# 3
Primary TaxonomyN
Taxonomy Code207XX0801X
TaxonomyOrthopaedic Trauma Physician
License NumberMD11756
License Number StateDC
# 4
Primary TaxonomyN
Taxonomy Code207XX0801X
TaxonomyOrthopaedic Trauma Physician
License NumberD0030901
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: