Provider Demographics
NPI:1639511595
Name:COOPER, MYE (DO)
Entity Type:Individual
Prefix:DR
First Name:MYE
Middle Name:
Last Name:COOPER
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 WOODLAWN RD
Mailing Address - Street 2:
Mailing Address - City:ALIQUIPPA
Mailing Address - State:PA
Mailing Address - Zip Code:15001-5410
Mailing Address - Country:US
Mailing Address - Phone:724-857-9640
Mailing Address - Fax:
Practice Address - Street 1:2350 NOBLESTOWN RD
Practice Address - Street 2:STE 110
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15205-4128
Practice Address - Country:US
Practice Address - Phone:412-304-2016
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-20
Last Update Date:2018-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH58.004964207P00000X
WV2924208D00000X
PAOS017537208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine