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Individual

DR. GERALD COOLEY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
10502 PARK RD, SUITE 100, CHARLOTTE, NC 28210-8479
(704) 542-1366
(704) 542-1063
Mailing address
10502 PARK RD, SUITE 100, CHARLOTTE, NC 28210-8479
(704) 542-1366
(704) 542-1063

Taxonomy

Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
9600496
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0212C
BCBS OF NC
NC
01
562078587
TAX ID
NC
Enumeration date
01/25/2006
Last updated
05/01/2008
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