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General NPI Number Information
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NPI Number | 1285837724
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Entity Type | Organization
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Legal Business Name | COOPER FAMILY MEDICINE PC
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Dates
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Enumeration Date | 06/11/2007
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Last Update Date | 05/13/2008
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Provider Practice Location Address
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Address Line | 1050 KINGS HWY N SUITE 105
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City | CHERRY HILL
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State | NJ
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Zip | 08034-1909
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Country | US
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Telephone | 856-321-0303
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Fax | 856-321-0090
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Provider Business Mailing Address
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Address Line | 3 COOPER PLZ SUITE 502
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City | CAMDEN
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State | NJ
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Zip | 08103-1438
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Country | US
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Telephone | 856-342-2921
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Fax | 856-968-8499
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Authorized Official
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Title or Position | EVP MANAGED CARE
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Name | ROBERT MCMULLEN
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Credential |
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Telephone | 856-342-2921
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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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