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Individual

DR. MARK I KOHN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
3401 N BROAD ST, PHILADELPHIA, PA 19140-5103
(215) 707-7237
(215) 707-9389
Mailing address
2450 W HUNTING PARK AVE, PHILADELPHIA, PA 19129-1302
(215) 707-7237
(215) 707-9389

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
25MA08164200
NJ
2085R0202X
Diagnostic Radiology Physician
Primary
MD032981E
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
001114463
AMERICHOICE OF PA
PA
05
001114463
PA
05
0011144630004
PA
01
0110323000
IBC KHPE
PA
05
0127175
NJ
01
1031977
KEYSTONE MERCY
PA
01
120683
PHCS
PA
01
231955165
AETNA USHC
PA
01
300025834
RAILROAD MEDICARE
PA
01
512306
HIGHMARK BLUE SHIELD
PA
01
MD032981E
HEALTH PARTNERS
PA
01
P00398000
RRML
NJ
01
PA7584
HEALTHNET
PA
Enumeration date
01/20/2006
Last updated
04/19/2012
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