Basic Information
| Provider Information | |||||||||
| NPI: | 1700815206 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | COHEN | ||||||||
| FirstName: | JOSEPH | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 896206 | ||||||||
| Address2: | |||||||||
| City: | CHARLOTTE | ||||||||
| State: | NC | ||||||||
| PostalCode: | 282896206 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2528080145 | ||||||||
| FaxNumber: | 2528082770 | ||||||||
| Practice Location | |||||||||
| Address1: | 4252 ARENDELL ST | ||||||||
| Address2: | SUITE E | ||||||||
| City: | MOREHEAD CITY | ||||||||
| State: | NC | ||||||||
| PostalCode: | 285572866 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2528080145 | ||||||||
| FaxNumber: | 2528082770 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/30/2006 | ||||||||
| LastUpdateDate: | 03/17/2017 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RC0000X | 2005-01871 | NC | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Cardiovascular Disease |
ID Information
| ID | Type | State | Issuer | Description | 142HG | 01 | NC | BCBS | OTHER | 5903824 | 05 | NC | MEDICAID | CO583849 | 01 | NC | MEDICARE ID | OTHER |