Organization
COOPER SURGICAL ASSOCIATES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT MCMULLEN (EVP MANAGED CARE ADMINATRATION)
(856) 342-7369
Entity
Organization
Contact information
Practice address
1103 KINGS HWY N, SUITE 101, CHERRY HILL, NJ 08034-1983
(856) 667-0404
Mailing address
3 COOPER PLZ, SUITE 502, CAMDEN, NJ 08103-1438
(856) 968-7433
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0241533000
AMERIHEALTH GRP NUMBER
—
05
—
2865807
—
NJ
Enumeration date
03/27/2007
Last updated
08/22/2020
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