Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RA0201X | Internist - Allergy & Immunology | 027520 | GA |
NPI | 1689614885 |
---|---|
Provider Name | Robert Martin Cohen |
First Address | Conyers, GA 30013-2186 |
Second Address | Conyers, GA 30013-2186 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/06/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
D87765 | (02) | GA |