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Individual

CRYSTAL COOPER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
24911 LITTLE MACK AVE STE C, SAINT CLAIR SHORES, MI 48080-3200
(586) 777-2050
(586) 777-2189
Mailing address
24911 LITTLE MACK AVE STE C, SAINT CLAIR SHORES, MI 48080-3200
(586) 777-2050
(586) 777-2189

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
036153220
IL
207Q00000X
Family Medicine Physician
4301112029
MI
207Q00000X
Family Medicine Physician
Primary
EMC0001216
MI

Other

Enumeration date
06/12/2017
Last updated
01/10/2022
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