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1700865771

NPI Code Detail

MEDICARE: MR. COREY MICHAEL COHEN MD

MEDICARE: MR. COREY MICHAEL COHEN MD

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	207P00000X	Emergency Medicine Physician	29465	KY

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
4	930059279	OTHER		RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	1063868	OTHER	KY	PASSPORT

General Provider Information

NPI Number	:	1700865771
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. COREY MICHAEL COHEN MD

Provider Business Mailing Address
First Line	:	PO BOX 909
Second Line	:
City	:	LOUISVILLE
State	:	KY
Zip	:	40201-0909
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	200 ABRAHAM FLEXNOR WAY
Second Line	:
City	:	LOUISVILLE
State	:	KY
Zip	:	40202-1818
Country	:	US
Telephone Number	:	502-587-4421
Fax Number	:	502-361-9947

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

Provider Enumeration Date	:	01/10/2006
Last Update Date	:	11/23/2020

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Directions to “ MR. COREY MICHAEL COHEN MD” Practice Location

Language	Start Address	Practice Location

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