Individual
MR. COOPER MICHAEL WHITE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
6227 THOMPSON RD, SYRACUSE, NY 13206-1405
(315) 937-2007
Mailing address
7 QUAKER HILL RD, SYRACUSE, NY 13224-2011
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
026079
NY
Other
Enumeration date
12/13/2020
Last updated
12/13/2020
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