Healthcare Provider Details

I. General information

NPI: 1811939762
Provider Name (Legal Business Name): ADAM S COOPER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/12/2006
Last Update Date: 12/12/2025
Certification Date: 12/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

28711 8 MILE RD STE C
LIVONIA MI
48152-2041
US

IV. Provider business mailing address

26901 BEAUMONT BLVD STE 3D
SOUTHFIELD MI
48033-3849
US

V. Phone/Fax

Practice location:
  • Phone: 248-474-4590
  • Fax: 248-888-9127
Mailing address:
  • Phone: 947-522-1862
  • Fax: 947-522-0307

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number4301061166
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: