Individual
DR. KEVIN L. COOPER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2351 E 22ND ST, CLEVELAND, OH 44115-3111
(216) 861-6200
(216) 363-2757
Mailing address
7580 NORTHCLIFF AVE, SUITE 500, BROOKLYN, OH 44144-3270
(216) 472-2741
(216) 472-2740
Taxonomy
Speciality
Code
Description
License number
State
207ZP0101X
Anatomic Pathology Physician
Primary
35057833
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000485841
ANTHEM BCBS
OH
05
—
0893458
—
OH
01
—
2765635
UNITED HEALTHCARE
OH
01
—
341091834009
TRICARE
OH
01
—
341091834050
MEDICAL MUTUAL
OH
01
—
5429209
AETNA
OH
01
—
P00402409
RAILROAD MEDICARE
OH
Enumeration date
05/04/2006
Last updated
07/02/2013
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