Individual
COOPER BLAZEK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
16645 BIRKDALE COMMONS PKWY # 100A, HUNTERSVILLE, NC 28078-5669
(170) 480-1739
Mailing address
5761 CEDERMERE DRIVE, WINSTON SALEM, NC 27106
(336) 688-6012
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
2025-01811
NC
Other
Enumeration date
04/12/2022
Last updated
11/21/2025
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