Individual
DR. JUSTIN DAVID COHEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3415 MACCORKLE AVENUE SE, CHARLESTON, WV 25304
(304) 388-8380
(304) 388-8395
Mailing address
3415 MACCORKLE AVENUE SE, CHARLESTON, WV 25304
(304) 388-8380
(304) 388-8395
Taxonomy
Speciality
Code
Description
License number
State
207RX0202X
Medical Oncology Physician
Primary
19662
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0082381-000
—
WV
01
—
900002314
RAILROAD MEDICARE
—
Enumeration date
04/11/2006
Last updated
08/07/2015
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