Healthcare Provider Details

I. General information

NPI: 1376647883
Provider Name (Legal Business Name): SHARI R COHEN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SHARI R COHEN MD

II. Dates (important events)

Enumeration Date: 09/13/2006
Last Update Date: 07/29/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9 PARK CENTER COURT #150
OWINGS MILLS MD
21117
US

IV. Provider business mailing address

9 PARK CENTER COURT #150
OWINGS MILLS MD
21117
US

V. Phone/Fax

Practice location:
  • Phone: 410-902-7710
  • Fax: 410-902-4410
Mailing address:
  • Phone: 410-902-7710
  • Fax: 410-902-4410

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberD0044893
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: