Provider Demographics
NPI:1154322709
Name:COOPER, WILLIAM H IV (MD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:H
Last Name:COOPER
Suffix:IV
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1500 MEDICAL CENTER DR
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28401-7507
Mailing Address - Country:US
Mailing Address - Phone:910-763-9509
Mailing Address - Fax:910-763-1058
Practice Address - Street 1:1500 MEDICAL CENTER DR
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28401-7507
Practice Address - Country:US
Practice Address - Phone:910-763-9509
Practice Address - Fax:910-763-1058
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-04
Last Update Date:2010-08-30
Deactivation Date:2006-03-22
Deactivation Code:
Reactivation Date:2006-04-07
Provider Licenses
StateLicense IDTaxonomies
NC28957207VE0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VE0102XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyReproductive Endocrinology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC01177OtherBCBS
NC01177OtherBCBS
NCC81998Medicare UPIN