Provider Demographics
NPI:1063438927
Name:VON KOHORN, ISABELLE (MD, PHD)
Entity type:Individual
Prefix:DR
First Name:ISABELLE
Middle Name:
Last Name:VON KOHORN
Suffix:
Gender:F
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3506 PATTERSON ST NW
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20015-2558
Mailing Address - Country:US
Mailing Address - Phone:203-535-9982
Mailing Address - Fax:
Practice Address - Street 1:4701 SANGAMORE RD STE N100
Practice Address - Street 2:
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20816-2558
Practice Address - Country:US
Practice Address - Phone:914-919-9200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-14
Last Update Date:2022-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA329398208000000X, 2080N0001X
CAA91179208000000X
MDD70742208000000X, 2080N0001X
MS29365208000000X, 2080N0001X
FLME152873208000000X, 2080N0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080N0001XAllopathic & Osteopathic PhysiciansPediatricsNeonatal-Perinatal Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A911790Medicaid
DC188771YT2Medicare PIN
CA00A911790Medicare PIN