Individual
STACY LORINE COOPER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
600 N WOLFE ST, BALTIMORE, MD 21287-0005
(410) 955-5000
Mailing address
6201 GREENLEIGH AVE, MIDDLE RIVER, MD 21220-2004
(410) 933-6421
Taxonomy
Speciality
Code
Description
License number
State
2080P0207X
Pediatric Hematology & Oncology Physician
Primary
D74065
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
D74065
LICENSE
MD
Enumeration date
04/22/2008
Last updated
09/09/2021
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