Individual provider · NPI-1

Michael Cooperstock, MD

Pediatrics, Pediatric Infectious Diseases · Columbia, MO

NPI number1497701023
StatusActive
Last updated in NPPESMar 17, 2018

Details

NPI
1497701023
Entity type
Individual (NPI-1)
Name
Michael Cooperstock
Credential
MD
Sex
Male
Sole proprietor
No
Enumeration date
May 25, 2006
Last updated
Mar 17, 2018

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
2080P0208X Pediatrics, Pediatric Infectious DiseasesR5666MOYes
208000000X PediatricsR5666MO

Practice location

404 N Keene St
Columbia, MO 65201-6626

Phone 573-882-6921

Mailing address

Po Box 843966
Kansas City, MO 64184-3966

Phone 573-882-3974 · Fax 573-884-0943

Other practice locations

402 N Keene St
Ste 101
Columbia, MO 65201-6986

Phone 573-882-6921 · Fax 573-882-1154

402 N Keene St
Ste 101
Columbia, MO 65201-6986

Phone 573-882-6921 · Fax 573-882-1154

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