Healthcare Provider Details

I. General information

NPI: 1245251685
Provider Name (Legal Business Name): DAVID AHRON COHEN M.D
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/21/2006
Last Update Date: 08/26/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1050 SOUTH NORTH POINT RD SUITE 101
BALTIMORE MD
21224
US

IV. Provider business mailing address

1050 SOUTH NORTH POINT RD SUITE 101
BALTIMORE MD
21224
US

V. Phone/Fax

Practice location:
  • Phone: 410-282-7600
  • Fax: 410-282-4802
Mailing address:
  • Phone: 410-282-7600
  • Fax: 410-282-4802

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207XX0005X
TaxonomySports Medicine (Orthopaedic Surgery) Physician
License Number0101241664
License Number StateVA
# 2
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberM68165
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: