Individual
MR. EDWARD BRADLEY COOMER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
1 MEDICAL CENTER BLVD, WINSTON SALEM, NC 27157-0001
(336) 716-6701
Mailing address
1890 LEGACY PARK APT 303, WINSTON SALEM, NC 27103-5787
(502) 640-5524
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
124084
NC
367500000X
Certified Registered Nurse Anesthetist
Primary
5953
NC
Other
Enumeration date
09/05/2018
Last updated
03/06/2025
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