Individual
MATTHEW S COHEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
630 EAST RIVER STREET ELYRIA, DEPARTMENT OF EMERGENCY MEDICINE, ELYRIA, OH 44035
(440) 329-7450
(440) 329-5814
Mailing address
2985 MILL RIDGE CIR NW, CANTON, OH 44708-5900
(605) 593-6408
(440) 329-5814
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
02003160A
IN
207Q00000X
Family Medicine Physician
34101583
OH
208600000X
Surgery Physician
Primary
7261
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1356360655
WELLMARK
SD
05
—
7302250
—
SD
Enumeration date
07/18/2006
Last updated
09/18/2012
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