Individual
MICHAEL S COHN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
130 FISHER RD, MOB-C, STE 1, BERLIN, VT 05602-9516
(802) 371-4820
(802) 371-4855
Mailing address
PO BOX 547, ATT: CVMC FINANCE DEPT, BARRE, VT 05641-0547
(802) 371-4820
(802) 371-4855
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
042.0012910
VT
208800000X
Urology Physician
24793
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000045849
ANTHEM
KY
05
—
1023136
—
VT
01
—
1048729
PASSPORT
KY
01
—
340008093
RAILROAD MEDICARE
KY
05
—
64247935
—
KY
01
—
Y400150328
MEDICARE PTAN LINKED TO CVMC MGP
VT
Enumeration date
07/18/2005
Last updated
08/01/2014
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