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General NPI Number Information
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NPI Number | 1235627282
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Entity Type | Organization
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Legal Business Name | ADAM C. COHEN PLASTIC SURGERY, LLC
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Dates
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Enumeration Date | 04/25/2018
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Last Update Date | 04/25/2018
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Provider Practice Location Address
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Address Line | 7150 CLEARVISTA DR
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City | INDIANAPOLIS
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State | IN
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Zip | 46256-1695
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Country | US
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Telephone | 317-621-6262
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Fax |
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Provider Business Mailing Address
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Address Line | 5265 N MERIDIAN ST
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City | INDIANAPOLIS
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State | IN
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Zip | 46208-2651
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Country | US
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Telephone | 317-254-8087
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Fax | 317-254-8087
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Authorized Official
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Title or Position | OWNER
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Name | ADAM C COHEN
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Credential | MD
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Telephone | 317-254-8087
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208200000X
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Taxonomy Name | Plastic Surgery Physician
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License Number | 01048031A
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License Number State | IN
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