Provider Demographics
NPI:1700042256
Name:COOPER, MICHELE M (MD)
Entity Type:Individual
Prefix:
First Name:MICHELE
Middle Name:M
Last Name:COOPER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:3600 PRYTANIA ST
Mailing Address - Street 2:SUITE 35
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70115-3628
Mailing Address - Country:US
Mailing Address - Phone:504-897-7197
Mailing Address - Fax:
Practice Address - Street 1:5646 READ BLVD STE 280
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70127-3144
Practice Address - Country:US
Practice Address - Phone:504-246-1452
Practice Address - Fax:504-309-4292
Is Sole Proprietor?:No
Enumeration Date:2008-08-04
Last Update Date:2019-03-06
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
LA023955207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
LAH48327Medicare UPIN
LA4A700Medicare PIN