Basic Information
| Provider Information | |||||||||
| NPI: | 1811071764 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | COHEN | ||||||||
| FirstName: | DIANA | ||||||||
| MiddleName: | LYNN | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | D.O. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 930 INDIANPIPE RD | ||||||||
| Address2: | |||||||||
| City: | LAKE ORION | ||||||||
| State: | MI | ||||||||
| PostalCode: | 483602614 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2483738060 | ||||||||
| FaxNumber: | 2488149304 | ||||||||
| Practice Location | |||||||||
| Address1: | 46 W SHADBOLT ST | ||||||||
| Address2: | |||||||||
| City: | LAKE ORION | ||||||||
| State: | MI | ||||||||
| PostalCode: | 483623170 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2488149300 | ||||||||
| FaxNumber: | 2488149304 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/25/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207V00000X | MI | Y | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology |
No ID Information.