Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204E00000X | Oral & Maxillofacial Surgeon | 4301069256 | MI |
NPI | 1497728380 |
---|---|
Provider Name | Dr. Brian H Cohen |
First Address | Dearborn, MI 48124-2943 |
Second Address | Dearborn, MI 48124-2943 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/02/2006 |
Last Update Date | 09/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000000002038 | CAPE PIN NUMBER (01) | MI |
0N14730 | HAP HMO PROVIDER NUMBER (01) | MI |
129802 | CARE CHOICES PROVIDER NO. (01) | MI |
C7487 | MCARE'S PROVIDER NUMBER (01) | MI |
H21006 | (02) | MI |