Individual
DR. MAXWELL IAN COOPER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1 MEDICAL CENTER BLVD, CHESTER, PA 19013-3902
(610) 447-2000
Mailing address
4536 BONNEY RD, VIRGINIA BEACH, VA 23462-3818
(757) 490-9388
(757) 490-9401
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
0101258678
VA
207P00000X
Emergency Medicine Physician
Primary
MD463855
PA
390200000X
Student in an Organized Health Care Education/Training Program
—
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
06937223
—
NJ
Enumeration date
03/27/2012
Last updated
06/23/2023
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