Individual
PAMELA ISABEL COOPER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
8820 S MERIDIAN ST STE 200, INDIANAPOLIS, IN 46217-6058
(317) 865-6700
(317) 865-6759
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
01086948A
IN
207R00000X
Internal Medicine Physician
4301089683
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
264430E08
MEDICARE
IN
05
—
300057866
—
IN
Enumeration date
06/26/2007
Last updated
01/23/2023
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