Individual
BETHANY R. COHEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
107 ST LIAM HALL, NOTRE DAME, IN 46556-5693
(574) 631-7497
(574) 631-6047
Mailing address
107 ST LIAM HALL, NOTRE DAME, IN 46556-5693
(574) 631-7497
(574) 631-6047
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01071880A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201110970
—
IN
Enumeration date
06/10/2011
Last updated
10/26/2022
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