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Individual

ERIC DAVID COHEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
405 W COUNTRY CLUB RD, ROSWELL, NM 88201-5209
(575) 624-4663
(575) 624-4907
Mailing address
405 W COUNTRY CLUB RD, ROSWELL, NM 88201-5209
(575) 624-4663
(575) 624-4907

Taxonomy

Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
14308
AL
207RC0000X
Cardiovascular Disease Physician
32942
AZ
207RC0000X
Cardiovascular Disease Physician
Primary
MD2019-0764
NM
207RI0011X
Interventional Cardiology Physician
32942
AZ
207RI0011X
Interventional Cardiology Physician
MD2019-0764
NM

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
009929395
AL
05
337603
AZ
05
36970832
NM
01
859420
MEDICARE PTAN / ROSWELL CLINIC CORP
NM
Enumeration date
12/28/2005
Last updated
09/07/2022
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