Individual
MARK C COOPER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1702 UNIVERSITY DR S, FARGO, ND 58103-4940
(701) 364-3300
(701) 364-8906
Mailing address
PO BOX 6001, FARGO, ND 58108-6001
(701) 364-3300
(701) 364-8906
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
Primary
5943
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10269
NDBS #
ND
01
—
142005
UCARE#
ND
05
—
16443
—
ND
01
—
2400032
MEDICA #
ND
01
—
2400078
MEDICA #
ND
05
—
276202100
—
ND
01
—
28131CO
MNBS #
ND
01
—
2F531CO
MNBS #
MN
01
—
34Q70CO
MNBS #
ND
01
—
4F531CO
MNBS #
MN
01
—
676557
AMERICA'S PPO/ARAZ #
ND
01
—
DA9011015524
PREFERRED ONE #
ND
01
—
HP25729
HEALTHPARTNERS #
ND
01
—
ND200010
LHS #
ND
Enumeration date
07/13/2006
Last updated
03/07/2023
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