Individual
STEPHEN U COHEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
609 CHRISTOPHER DR, PMG BELEN, BELEN, NM 87002-2615
(505) 864-5454
(505) 864-5450
Mailing address
PO BOX 26666, PHS PROVIDER ENROLLMENT, ALBUQUERQUE, NM 87125-6666
(505) 923-5356
(505) 923-5354
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
74138
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1396
—
NM
Enumeration date
08/01/2006
Last updated
10/24/2011
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