Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0103X | Foot & Ankle Surgery | 601 | GA |
NPI | 1063403087 |
---|---|
Provider Name | Dr. Scott Mitchell Cohen |
First Address | Woodstock, GA 30188-3680 |
Second Address | Woodstock, GA 30188-3680 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 31/10/2005 |
Last Update Date | 31/03/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000437918A | (05) | GA |
1002145 | AETNA HMO ID NUMBER (01) | GA |
102517001 | DMERC/MEDICARE ID# (01) | GA |
4250870 | AETNA NON HMO ID # (01) | GA |
480009356 | MEDICARE RAILROAD (01) | GA |
T81668 | (02) | GA |