Individual
BRENDA W COOPER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
11100 EUCLID AVE, CLEVELAND, OH 44106-1716
(216) 844-8500
Mailing address
24701 EUCLID AVE, 3RD FLOOR, EUCLID, OH 44117-1714
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
35-059171
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000224384
UNISON
—
01
—
000000539541
ANTHEM
—
01
—
0643890
AETNA
OH
05
—
0791415
—
OH
01
—
363443
WELLCARE
—
01
—
700006754
RAILROAD MEDICARE
OH
01
—
741816
BUCKEYE
—
01
—
P00449269
RAILROAD MEDICARE
OH
Enumeration date
07/19/2006
Last updated
12/19/2020
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