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General NPI Number Information
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NPI Number | 1174544035
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Entity Type | Organization
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Legal Business Name | ROBERT COOPER MD
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Dates
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Enumeration Date | 07/23/2006
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Last Update Date | 09/16/2008
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Provider Practice Location Address
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Address Line | 7635 W OKLAHOMA AVE SUITE #202
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City | MILWAUKEE
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State | WI
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Zip | 53219-3600
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Country | US
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Telephone | 414-327-9152
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Fax |
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Provider Business Mailing Address
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Address Line | 4555 W SCHROEDER DR SUITE #170
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City | MILWAUKEE
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State | WI
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Zip | 53223-1475
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Country | US
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Telephone | 414-365-3210
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Fax |
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Authorized Official
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Title or Position | OWNER/PRESIDENT
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Name | ROBERT COOPER
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Credential | MD
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Telephone | 414-327-9152
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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