Individual
WENDY COOPER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
N14W23900 STONE RIDGE DR, PROHEALTH CARE MEDICAL ASSOCIATES INC., WAUKESHA, WI 53188-1135
(262) 549-3030
Mailing address
N14W23900 STONE RIDGE DR, PROHEALTH CARE MEDICAL ASSOCIATES INC., WAUKESHA, WI 53188-1135
(262) 549-3030
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
28143
WI
208000000X
Pediatrics Physician
28143
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
30780600
—
WI
Enumeration date
02/09/2006
Last updated
11/15/2011
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