Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223S0112X | Oral and Maxillofacial Surgeon | 017120 | MI |
NPI | 1073585022 |
---|---|
Provider Name | Dr. Jeffrey S. Cohen |
First Address | West Bloomfield, MI 48323-2184 |
Second Address | West Bloomfield, MI 48323-2184 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/02/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1781844 | UNITED CONCRODIA (01) | MI |
5501140 | BLUE CARE NETWORK (01) | MI |
9756312600 | BLUE CROSS BLUE SHIELD (01) | MI |