Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VE0102X | Reproductive Endocrinologist | 28957 | NC |
NPI | 1154322709 |
---|---|
Provider Name | Dr. William H Cooper IV |
First Address | Wilmington, NC 28401-7507 |
Second Address | Wilmington, NC 28401-7507 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 04/08/2005 |
Last Update Date | 30/08/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01177 | BCBS (01) | NC |
C81998 | (02) | NC |