Provider Demographics
NPI:1992973721
Name:COSMA, CECILIA CRISTINA (MD)
Entity type:Individual
Prefix:DR
First Name:CECILIA
Middle Name:CRISTINA
Last Name:COSMA
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 1:42557 WOODWARD AVE
Mailing Address - Street 2:STE. 130
Mailing Address - City:BLOOMFIELD HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48304-5206
Mailing Address - Country:US
Mailing Address - Phone:248-322-3088
Mailing Address - Fax:248-322-4175
Practice Address - Street 1:44060 WOODWARD AVE
Practice Address - Street 2:STE. 104
Practice Address - City:BLOOMFIELD HILLS
Practice Address - State:MI
Practice Address - Zip Code:48302-5038
Practice Address - Country:US
Practice Address - Phone:248-454-0588
Practice Address - Fax:248-335-8857
Is Sole Proprietor?:No
Enumeration Date:2008-02-14
Last Update Date:2014-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301086469207R00000X, 208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI70-0-F32947-0OtherBCBS CPIN
MI1962478743OtherCARDIOLOGY AND VASCULAR ASSOCIATES PC GROUP NPI
MI1992973721Medicaid
MI700F37550OtherBCBS