| Robert M. Cooper, M.d,, Llc | |
|
6503 Park Heights Ave L-2 Baltimore MD 21215-3002 | |
| (410) 358-2397 | |
| (410) 358-2399 |
| Full Name | Robert M. Cooper, M.d,, Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 6503 Park Heights Ave, Baltimore, Maryland |
| Authorized Official Name and Position | Robert M Cooper (DOCTOR) |
| Authorized Official Contact | 4103582397 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Robert M. Cooper, M.d,, Llc 6503 Park Heights Ave L-2 Baltimore MD 21215-3002 Ph: (410) 358-2397 | Robert M. Cooper, M.d,, Llc 6503 Park Heights Ave L-2 Baltimore MD 21215-3002 Ph: (410) 358-2397 |
| NPI Number | 1225085426 |
|---|---|
| Provider Enumeration Date | 05/31/2006 |
| Last Update Date | 01/31/2019 |
| Medicare PECOS PAC ID | 9739245929 |
|---|---|
| Medicare Enrollment ID | O20090313000376 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1225085426 | NPI | - | NPPES |
| 396801400 | Medicaid | MD | |
| 424093600 | Medicaid | MD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0300X | Internal Medicine - Geriatric Medicine | (* (Not Available)) | Primary |
| Provider Name | Robert M Cooper |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1235159898 PECOS PAC ID: 5395801583 Enrollment ID: I20090313000358 |
| Provider Name | Rivka Bortz |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437708286 PECOS PAC ID: 2163855180 Enrollment ID: I20191205002066 |
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