Provider Demographics
NPI: | 1093949745 |
---|---|
Name: | COBAIN, ERIN FRANCES (MD) |
Entity type: | Individual |
Prefix: | |
First Name: | ERIN |
Middle Name: | FRANCES |
Last Name: | COBAIN |
Suffix: | |
Gender: | F |
Credentials: | MD |
Other - Prefix: | |
Other - First Name: | |
Other - Middle Name: | |
Other - Last Name: | |
Other - Suffix: | |
Other - Last Name Type: | |
Other - Credentials: | |
Mailing Address - Street 1: | 3621 S STATE ST |
Mailing Address - Street 2: | |
Mailing Address - City: | ANN ARBOR |
Mailing Address - State: | MI |
Mailing Address - Zip Code: | 48108-1633 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 734-647-5299 |
Mailing Address - Fax: | |
Practice Address - Street 1: | 1500 E MEDICAL CENTER DR FL B1 |
Practice Address - Street 2: | |
Practice Address - City: | ANN ARBOR |
Practice Address - State: | MI |
Practice Address - Zip Code: | 48109-5000 |
Practice Address - Country: | US |
Practice Address - Phone: | 734-936-4000 |
Practice Address - Fax: | |
Is Sole Proprietor?: | No |
Enumeration Date: | 2009-05-11 |
Last Update Date: | 2020-04-28 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
MI | 4301102346 | 207RX0202X, 207R00000X, 207RX0202X |
PA | MD443706 | 207R00000X |
PA | MT194932 | 390200000X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 207RX0202X | Allopathic & Osteopathic Physicians | Internal Medicine | Medical Oncology |
No | 207R00000X | Allopathic & Osteopathic Physicians | Internal Medicine | |
No | 390200000X | Student, Health Care | Student in an Organized Health Care Education/Training Program |