Healthcare Provider Details

I. General information

NPI: 1124201660
Provider Name (Legal Business Name): DAVID COHEN DPM, PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/06/2007
Last Update Date: 08/15/2024
Certification Date: 08/15/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9403 HARFORD RD
BALTIMORE MD
21234-3123
US

IV. Provider business mailing address

8002 BRYNMOR CT UNIT 103
BALTIMORE MD
21208-4359
US

V. Phone/Fax

Practice location:
  • Phone: 410-882-5400
  • Fax:
Mailing address:
  • Phone: 410-292-3134
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0131X
TaxonomyFoot Surgery Podiatrist
License Number00384
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code261QP1100X
TaxonomyPodiatric Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. DAVID COHEN
Title or Position: OWNER
Credential: DPM
Phone: 410-292-3134