Healthcare Provider Details

I. General information

NPI: 1588647721
Provider Name (Legal Business Name): DAVID J COOPER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/22/2005
Last Update Date: 11/06/2024
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1244 CORNERSTONE BOULEVARD
DOWNINGTOWN PA
19335-3357
US

IV. Provider business mailing address

1244 CORNERSTONE BOULEVARD
DOWNINGTOWN PA
19335-3357
US

V. Phone/Fax

Practice location:
  • Phone: 610-873-5437
  • Fax: 484-713-5073
Mailing address:
  • Phone: 610-873-5437
  • Fax: 484-713-5073

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberMD022905E
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: