Healthcare Provider Details

I. General information

NPI: 1659377877
Provider Name (Legal Business Name): DAVID COHEN DPM
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/22/2005
Last Update Date: 01/18/2024
Certification Date: 01/18/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9403 HARFORD RD
BALTIMORE MD
21234-3123
US

IV. Provider business mailing address

9403 HARFORD RD
BALTIMORE MD
21234-3123
US

V. Phone/Fax

Practice location:
  • Phone: 410-882-5400
  • Fax: 410-882-5977
Mailing address:
  • Phone: 410-882-5400
  • Fax: 410-882-5977

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number00385
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: