Healthcare Provider Details

I. General information

NPI: 1295661213
Provider Name (Legal Business Name): COOPER SHARKANSKY
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/18/2026
Last Update Date: 06/18/2026
Certification Date: 06/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 UNIVERSITY PKWY
HIGH POINT NC
27268-0002
US

IV. Provider business mailing address

16 FLINT LN
NORTH EASTON MA
02356-2569
US

V. Phone/Fax

Practice location:
  • Phone: 336-841-9000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: