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Individual

DR. LANCE ADAM COHEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D

Contact information

Practice address
20701 N SCOTTSDALE RD, #107-499, SCOTTSDALE, AZ 85255-6413
(602) 980-1009
(480) 563-4709
Mailing address
22025 N 79TH PL, SCOTTSDALE, AZ 85255-4893
(480) 563-4706
(480) 563-4709

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
24583
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000600845
ANTHEM
01
000023036Y
HUMANA ID
01
00533097
MEDICARE
KY
01
102109
SIHO
05
200937670
IN
01
3703234000
PASSPORT ADVANTAGE
01
50023051
PASSPORT PROVIDER ID
05
7100073560
KY
Enumeration date
04/14/2006
Last updated
10/12/2009
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