Provider Demographics
NPI:1811939762
Name:COOPER, ADAM S (MD)
Entity type:Individual
Prefix:
First Name:ADAM
Middle Name:S
Last Name:COOPER
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:26901 BEAUMONT BLVD STE 3D
Mailing Address - Street 2:
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48033-3849
Mailing Address - Country:US
Mailing Address - Phone:947-522-1862
Mailing Address - Fax:947-522-0307
Practice Address - Street 1:28711 8 MILE RD STE C
Practice Address - Street 2:
Practice Address - City:LIVONIA
Practice Address - State:MI
Practice Address - Zip Code:48152-2041
Practice Address - Country:US
Practice Address - Phone:248-474-4590
Practice Address - Fax:248-888-9127
Is Sole Proprietor?:No
Enumeration Date:2006-06-12
Last Update Date:2020-10-26
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Provider Licenses
StateLicense IDTaxonomies
MI4301061166207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
5928561OtherAETNA
MIP63276OtherBLUE CROSS BLUE SHIELD
MIC5775OtherMCARE
MI4095281Medicaid
MI127727OtherCARE CHOICES
MI127727OtherCARE CHOICES
F37116006Medicare ID - Type Unspecified
MI4095281Medicaid