Individual
MARY A COOPER I
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1001 N MADISON AVE, GREENWOOD, IN 46142-4135
(317) 888-3508
(317) 888-5968
Mailing address
1040 SIERRA DR STE 400, GREENWOOD, IN 46143-7241
(317) 528-4800
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
01032763A
IN
207Q00000X
Family Medicine Physician
Primary
01032763
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200386390
—
IN
Enumeration date
12/29/2005
Last updated
03/22/2021
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