Individual
DAVID COOPER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1000 BLYTHE BLVD, CHARLOTTE, NC 28203-5812
(704) 355-2000
Mailing address
1701 GARDEN TERRACE, APT 11, CHARLOTTE, NC 28203-5855
(706) 436-1446
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
223357
NC
367500000X
Certified Registered Nurse Anesthetist
Primary
2754
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8054126
—
NC
05
—
NAN018
—
SC
Enumeration date
12/17/2010
Last updated
01/02/2020
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