Provider Demographics
NPI:1841486727
Name:LANE-COOPER, CHERELLE ARRA (DO)
Entity type:Individual
Prefix:
First Name:CHERELLE
Middle Name:ARRA
Last Name:LANE-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 1:9106 PHILADELPHIA RD STE 200
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21237-4333
Mailing Address - Country:US
Mailing Address - Phone:410-780-1980
Mailing Address - Fax:410-780-1984
Practice Address - Street 1:9106 PHILADELPHIA RD STE 200
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21237-4333
Practice Address - Country:US
Practice Address - Phone:410-780-1980
Practice Address - Fax:410-780-1984
Is Sole Proprietor?:No
Enumeration Date:2007-09-24
Last Update Date:2019-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDH0048247207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine