MEDICARE: PETER RONALD COHEN M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084P0800X	Psychiatry Physician	D0027122	MD
2	2084P0804X	Child & Adolescent Psychiatry Physician	D0027122	MD

General Provider Information

NPI Number	:	1033118617
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PETER RONALD COHEN M.D.

Provider Business Mailing Address
First Line	:	5450 KNOLL NORTH DR
Second Line	:
City	:	COLUMBIA
State	:	MD
Zip	:	21045-2373
Country	:	US
Telephone Number	:	410-715-1180
Fax Number	:	410-715-1182

Provider Business Practice Location Address
First Line	:	5450 KNOLL NORTH DR
Second Line	:
City	:	COLUMBIA
State	:	MD
Zip	:	21045-2373
Country	:	US
Telephone Number	:	410-715-1180
Fax Number	:	410-715-1182

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/18/2005
Last Update Date	:	02/01/2017

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