Individual
LAWRENCE MICHAEL COHEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
5104 BRADLEY BLVD, CHEVY CHASE, MD 20815-6526
(952) 595-1100
(952) 942-3361
Mailing address
11995 SINGLETREE LN, SUITE 500, EDEN PRAIRIE, MN 55344-5347
(952) 595-1100
(952) 942-3361
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
D0034540
MD
2085R0202X
Diagnostic Radiology Physician
MD14295
DC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
300135370
RR MEDICARE
—
05
—
330581301
—
MD
01
—
470001526
RR MEDICARE
—
Enumeration date
12/05/2005
Last updated
02/11/2011
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