Organization
COOPER PEDIATRIC SPECIALIST
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT MCMULLEN (EVP MANAGED CARE)
(856) 342-7369
Entity
Organization
Contact information
Practice address
4 PLAZA DR STE 401, BUNKER HILL PLAZA, SEWELL, NJ 08080-2747
(856) 270-4050
Mailing address
3 COOPER PLZ, SUITE 502, CAMDEN, NJ 08103-1438
(856) 968-7433
Taxonomy
Speciality
Code
Description
License number
State
2080P0206X
Pediatric Gastroenterology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9024603
—
NJ
Enumeration date
04/02/2007
Last updated
08/22/2020
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