MEDICARE: DR. STEPHEN ERIC COHEN D.C.

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	111N00000X	Chiropractor	2485	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	9992691	OTHER	NC	CIGNA HEALTHCARE PROVIDER
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	615027	OTHER	NC	ACN PROVIDER NO.
4	0831V	OTHER	NC	BCBS OF NC PROVIDER NO.

General Provider Information

NPI Number	:	1861450082
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. STEPHEN ERIC COHEN D.C.

Provider Business Mailing Address
First Line	:	1300 BAXTER ST
Second Line	:	SUITE 220
City	:	CHARLOTTE
State	:	NC
Zip	:	28204-3053
Country	:	US
Telephone Number	:	704-333-5313
Fax Number	:	704-333-7503

Provider Business Practice Location Address
First Line	:	1300 BAXTER ST
Second Line	:	SUITE 220
City	:	CHARLOTTE
State	:	NC
Zip	:	28204-3053
Country	:	US
Telephone Number	:	704-333-5313
Fax Number	:	704-333-7503

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

Provider Enumeration Date	:	05/04/2006
Last Update Date	:	07/08/2007

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