Basic Information
| Provider Information | |||||||||
| NPI: | 1902915572 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | COBB | ||||||||
| FirstName: | MEGAN | ||||||||
| MiddleName: | JENNIFER | ||||||||
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| Credential: | MD, DPT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 8522 VALLEYFIELD RD | ||||||||
| Address2: | |||||||||
| City: | LUTHERVILLE | ||||||||
| State: | MD | ||||||||
| PostalCode: | 210933933 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4103372765 | ||||||||
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| Practice Location | |||||||||
| Address1: | 500 UPPER CHESAPEAKE DR | ||||||||
| Address2: | |||||||||
| City: | BEL AIR | ||||||||
| State: | MD | ||||||||
| PostalCode: | 21014 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4436432110 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 08/29/2006 | ||||||||
| LastUpdateDate: | 04/03/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2080P0204X | D0085345 | MD | N | Allopathic & Osteopathic Physicians | Pediatrics | Pediatric Emergency Medicine | 225100000X | PT22165 | FL | N | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | 207P00000X | D0085345 | MD | Y | Allopathic & Osteopathic Physicians | Emergency Medicine |
No ID Information.