Healthcare Provider Details

I. General information

NPI: 1245298678
Provider Name (Legal Business Name): LAWRENCE F COHEN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/03/2006
Last Update Date: 07/24/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

150 W MAIN ST
DANVILLE VA
24541-2823
US

IV. Provider business mailing address

PO BOX 16534
CHAPEL HILL NC
27516-6534
US

V. Phone/Fax

Practice location:
  • Phone: 434-792-6326
  • Fax: 434-792-5122
Mailing address:
  • Phone: 919-967-6646
  • Fax: 919-967-6647

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number010142894
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: