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NPI Code Detail

MEDICARE: MICHAEL LEO COOPER M.D.

MEDICARE: MICHAEL LEO COOPER M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207R00000XInternal Medicine PhysicianR4834MO

General Provider Information

NPI Number : 1487784112
Entity Type Code : Individual
Provider Name (Legal Business Name) : MICHAEL LEO COOPER M.D.
Provider Business Mailing Address
First Line : 440 TERRACE TRL E
Second Line :
City : LAKE QUIVIRA
State : KS
Zip : 66217-8505
Country : US
Telephone Number : 913-268-5068
Fax Number :
Provider Business Practice Location Address
First Line : 1010 CARONDELET DR STE 308
Second Line :
City : KANSAS CITY
State : MO
Zip : 64114-4823
Country : US
Telephone Number : 816-942-5516
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/06/2007
Last Update Date : 07/08/2007

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Directions to “ MICHAEL LEO COOPER M.D.” Practice Location

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