Healthcare Provider Details

I. General information

NPI: 1194169730
Provider Name (Legal Business Name): EDWARD SAWYER COOPER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/25/2013
Last Update Date: 12/21/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6710 LINCOLN DRIVE
PHILADELPHIA PA
19119
US

IV. Provider business mailing address

6710 LINCOLN DRIVE
PHILADELPHIA PA
19119
US

V. Phone/Fax

Practice location:
  • Phone: 215-849-8234
  • Fax:
Mailing address:
  • Phone: 215-849-8234
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number003785-E
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: