Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2082S0105X | Plastic Hand Surgeon | 01048031A | IN |
Y | 2086S0122X | Plastic and Reconstructive Surgery | 01048031A | IN |
NPI | 1508819210 |
---|---|
Provider Name | Adam C Cohen |
First Address | Indianapolis, IN 46250-2890 |
Second Address | Indianapolis, IN 46256 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 17/05/2006 |
Last Update Date | 17/09/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
200393370 | (05) | IN |
H19579 | (02) |