Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Q00000X | Family Doctor | DR.00058920 | CO |
N | 207QS0010X | Family Doctor - Sports Medicine | DR.00058920 | CO |
NPI | 1033596432 |
---|---|
Provider Name | Spencer Cooperman |
First Address | Denver, CO 80218-3670 |
Second Address | Denver, CO 80218-3670 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/05/2015 |
Last Update Date | 09/12/2019 |