Provider Demographics
NPI:1538168232
Name:COHN, CHARLES DAVID (MD)
Entity type:Individual
Prefix:
First Name:CHARLES
Middle Name:DAVID
Last Name:COHN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:755 MOUNT VERNON HWY NE
Mailing Address - Street 2:STE 400
Mailing Address - City:SANDY SPRINGS
Mailing Address - State:GA
Mailing Address - Zip Code:30328-4274
Mailing Address - Country:US
Mailing Address - Phone:404-252-4100
Mailing Address - Fax:404-252-6740
Practice Address - Street 1:755 MOUNT VERNON HWY NE
Practice Address - Street 2:STE 400
Practice Address - City:SANDY SPRINGS
Practice Address - State:GA
Practice Address - Zip Code:30328-4274
Practice Address - Country:US
Practice Address - Phone:404-252-4100
Practice Address - Fax:404-252-6740
Is Sole Proprietor?:No
Enumeration Date:2005-07-15
Last Update Date:2021-02-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GA047722207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA809263612DMedicaid
GA202I110261Medicare PIN
GA809263612DMedicaid
GA11SCCXCMedicare PIN