Individual
CARRIE E COHEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
775 N EDWARDS AVE, WICHITA, KS 67203-4937
(316) 858-1111
(316) 946-5293
Mailing address
775 N EDWARDS AVE, WICHITA, KS 67203-4937
(316) 858-1111
(316) 946-5293
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
0530647
KS
208M00000X
Hospitalist Physician
0530647
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
105306
BLUE CROSS BLUE SHIELD
KS
05
—
200265810E
—
KS
Enumeration date
04/17/2006
Last updated
06/06/2023
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