| Doctor Name: | MICHAEL J COBB |
| NPI Number: | 1003813866 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PA |
| License Number: | PA00255 |
| Business Practice Address: | 298 W Exchange St Providence, RI - 029031025 |
| Business Phone Number: | 4012705900 |
| Business Fax Number: | 4012704800 |
| Mailing Address: | 298 W Exchange St, PROVIDENCE |
| State: | RI |
| Postal Code: | 029031025 |
| Phone Number: | 4012705900 |
| Fax Number: | 4012704800 |
| NPI Enumeration Date: | 07/07/2005 |
| NPI Last Update Date: | 05/11/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363AS0400X |
| License Number: | PA00255 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | RI |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Physician Assistant |
| Taxonomy Specialization: | Surgical |
| Taxonomy Definition: | |