Organization
COOPER FAMILY MEDICINE PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT MCMULLEN (EVP MANAGED CARE)
(856) 342-2921
Entity
Organization
Contact information
Practice address
639 COOPER ST, B-12, CAMDEN, NJ 08102-1116
(856) 614-5603
(856) 614-5603
Mailing address
3 COOPER PLZ, SUITE 502, CAMDEN, NJ 08103-1438
(856) 342-2921
(856) 968-8499
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2218882004
AMERIHEALTH GROUP #
NJ
05
—
6558101
—
NJ
Enumeration date
06/07/2007
Last updated
05/13/2008
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