Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RC0000X | Internist - Cardiovascular Disease | MD14693 | ME |
NPI | 1023044096 |
---|---|
Provider Name | Dr. Mylan C. Cohen |
First Address | Scarborough, ME 04074 |
Second Address | Scarborough, ME 04074 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/06/2006 |
Last Update Date | 29/01/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
025039 | ANTHEM (01) | |
207450099 | (05) | ME |
30011330 | (05) | NH |
E30934 | (02) |