Healthcare Provider Details

I. General information

NPI: 1356302475
Provider Name (Legal Business Name): NELSON LEE KOHN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 03/29/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2401 W BELVEDERE AVE SINAI HOSPITAL - DEPT. OF PM & R
BALTIMORE MD
21215-5216
US

IV. Provider business mailing address

6 SWANHILL DR
BALTIMORE MD
21208-1927
US

V. Phone/Fax

Practice location:
  • Phone: 410-601-5918
  • Fax:
Mailing address:
  • Phone: 410-484-7898
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2081P2900X
TaxonomyPain Medicine (Physical Medicine & Rehabilitation) Physician
License NumberD45709
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: