Individual
MICHAEL JOHN COBB
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
962 WARWICK AVE, WARWICK, RI 02888-3650
(401) 612-7100
(774) 565-0469
Mailing address
104 CAMERON WAY, REHOBOTH, MA 02769-2126
(813) 326-7937
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA00255
RI
363AS0400X
Surgical Physician Assistant
PA00255
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7008957
—
RI
Enumeration date
07/07/2005
Last updated
05/13/2020
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