Individual
DR. MICHAEL ROBERT COHEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
1000 TOWNE CENTER BLVD, SUITE 701, POOLER, GA 31322-4052
(912) 748-2280
(912) 748-4988
Mailing address
PO BOX 15849, SAVANNAH, GA 31416-2549
(912) 748-2280
(912) 748-4988
Taxonomy
Speciality
Code
Description
License number
State
207QA0505X
Adult Medicine Physician
Primary
2005-00695
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
065646
GA MEDICAL LICENSE
GA
01
—
144AY
BCBSNC
NC
01
—
194192
MEDCOST
NC
01
—
2834791
CIGNA HEALTHCARE
NC
05
—
5905703
—
NC
Enumeration date
08/30/2006
Last updated
04/25/2011
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