Healthcare Provider Details

I. General information

NPI: 1780626580
Provider Name (Legal Business Name): ALAN COHEN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/13/2006
Last Update Date: 12/20/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10215 FERNWOOD RD SUITE 602
BETHESDA MD
20817-1106
US

IV. Provider business mailing address

4110 ASPEN HILL RD SUITE 200
ROCKVILLE MD
20853-2853
US

V. Phone/Fax

Practice location:
  • Phone: 301-530-6646
  • Fax:
Mailing address:
  • Phone: 301-438-5150
  • Fax: 301-460-0199

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License NumberD0022788
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: