Organization
MARVYN D. COHEN MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARVYN D COHEN MD (PHYSICIAN)
(706) 324-0355
Entity
Organization
Contact information
Practice address
500 18TH STREET, STE B20, COLUMBUS, GA 31901-1585
(706) 324-0355
(706) 324-4773
Mailing address
500 18TH STREET, STE B20, COLUMBUS, GA 31901-1585
(706) 324-0355
(706) 324-4773
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
11213
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00024505A
—
GA
01
—
008406710
MEDICAID
AL
Enumeration date
08/19/2008
Last updated
08/19/2008
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