Healthcare Provider Details

I. General information

NPI: 1992058952
Provider Name (Legal Business Name): GAD COHEN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/16/2012
Last Update Date: 03/11/2020
Certification Date: 03/11/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8905 HEMPSTEAD AVE
BETHESDA MD
20817-3560
US

IV. Provider business mailing address

8905 HEMPSTEAD AVE
BETHESDA MD
20817-3560
US

V. Phone/Fax

Practice location:
  • Phone: 240-752-7133
  • Fax:
Mailing address:
  • Phone: 240-752-7133
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QC1500X
TaxonomyCommunity Health Clinic/Center
License Number21290
License Number StateZZ
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number21290
License Number StateZZ
# 3
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number21290
License Number StateZZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: