Individual
MICHAEL COHEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
24 ONVILLE RD, SUITE 205, STAFFORD, VA 22556-3831
(540) 658-0825
(540) 658-0835
Mailing address
24 ONVILLE RD, SUITE 205, STAFFORD, VA 22556-3831
(540) 658-0825
(540) 658-0835
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
0101032992
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
005804086
—
VA
01
—
285621
ANTHEM BC BS
VA
01
—
30860001
CAREFIRST BC BS
VA
01
—
372340481
HEALTHNET
VA
Enumeration date
10/07/2005
Last updated
01/21/2010
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