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NPI Code Detail

MEDICARE: DR. G MICHAEL COOPER MD

MEDICARE: DR. G MICHAEL COOPER MD
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
1207Q00000XFamily Medicine PhysicianMD00026475WA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1578593125
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. G MICHAEL COOPER MD
Provider Business Mailing Address
First Line : PO BOX 1600
Second Line :
City : VANCOUVER
State : WA
Zip : 98668-1600
Country : US
Telephone Number : 360-514-7550
Fax Number : 360-514-7553
Provider Business Practice Location Address
First Line : 8716 E MILL PLAIN BLVD
Second Line :
City : VANCOUVER
State : WA
Zip : 98664-2531
Country : US
Telephone Number : 360-514-7550
Fax Number : 360-514-7553
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/03/2006
Last Update Date : 07/08/2007

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Directions to “ DR. G MICHAEL COOPER MD” Practice Location

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