Robert L Cooper, MD

Individual provider Active NPI Internal Medicine Physician · Medway, MA

NPI 1295917573 · NPPES record last updated Oct 19, 2012

Key facts

NPI
1295917573
Entity type
Individual (NPI type 1)
Primary specialty
Internal Medicine Physician 207R00000X
License
56803 (MA)
Practice address
81B Main St
Medway, MA 02053-1812
Phone
(508) 533-4377
NPI assigned
Nov 29, 2007
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Doctor of Medicine

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 56803 MA Yes

Addresses

Primary practice location

81B Main St
Medway, MA 02053-1812

Mailing address

81B Main St
Medway, MA 02053-1812

Other identifiers

IdentifierTypeStateIssuer
J05808OtherMABCBS
9767614MedicaidMA

Other providers in Medway, MA

All providers in Medway, MA · Internal Medicine Physician in Massachusetts

Sources for this page

Verify at the official NPI Registry.