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Individual

DR. STEVEN J COHEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
7910 W JEFFERSON BLVD, STE 201, FORT WAYNE, IN 46804-4159
(260) 436-3789
(260) 436-2703
Mailing address
7910 W JEFFERSON BLVD, STE 201, FORT WAYNE, IN 46804-4159
(260) 436-3789
(260) 436-2703

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
01025325A
IN
2080P0210X
Pediatric Nephrology Physician
01025325A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100360920
IN
Enumeration date
06/14/2005
Last updated
04/22/2008
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