Healthcare Provider Details

I. General information

NPI: 1154422418
Provider Name (Legal Business Name): PHILIP HOWARD COHEN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/26/2006
Last Update Date: 11/02/2026
Certification Date: 11/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

755 MOUNT VERNON HWY NE STE 500
SANDY SPRINGS GA
30328-4280
US

IV. Provider business mailing address

755 MOUNT VERNON HWY NE STE 500
SANDY SPRINGS GA
30328-4280
US

V. Phone/Fax

Practice location:
  • Phone: 678-252-6395
  • Fax: 404-252-6720
Mailing address:
  • Phone: 678-252-6395
  • Fax: 404-252-3720

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RS0010X
TaxonomySports Medicine (Internal Medicine) Physician
License Number114832
License Number StateGA
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number114832
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: