Provider Demographics
NPI:1588647721
Name:COOPER, DAVID JOHN (MD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:JOHN
Last Name:COOPER
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Gender:M
Credentials:MD
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Mailing Address - Street 1:690 WEST LINCOLN HIGHWAY
Mailing Address - Street 2:CHESTER COUNTY PEDIATRICS
Mailing Address - City:EXTON
Mailing Address - State:PA
Mailing Address - Zip Code:19341-2503
Mailing Address - Country:US
Mailing Address - Phone:610-873-5437
Mailing Address - Fax:484-879-6395
Practice Address - Street 1:690 WEST LINCOLN HIGHWAY
Practice Address - Street 2:CHESTER COUNTY PEDIATRICS
Practice Address - City:EXTON
Practice Address - State:PA
Practice Address - Zip Code:19341-2503
Practice Address - Country:US
Practice Address - Phone:610-873-5437
Practice Address - Fax:484-879-6395
Is Sole Proprietor?:No
Enumeration Date:2005-11-22
Last Update Date:2012-05-04
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Provider Licenses
StateLicense IDTaxonomies
PAMD022905E208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0009412630012Medicaid
PA0009412630012Medicaid