Basic Information
| Provider Information | |||||||||
| NPI: | 1457649501 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | COOPER | ||||||||
| FirstName: | KAREEM | ||||||||
| MiddleName: | CHARLES | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2700 WAYNE MEMORIAL DR | ||||||||
| Address2: | |||||||||
| City: | GOLDSBORO | ||||||||
| State: | NC | ||||||||
| PostalCode: | 275349494 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9197361110 | ||||||||
| FaxNumber: | 9197347570 | ||||||||
| Practice Location | |||||||||
| Address1: | 2700 WAYNE MEMORIAL DR | ||||||||
| Address2: | |||||||||
| City: | GOLDSBORO | ||||||||
| State: | NC | ||||||||
| PostalCode: | 275349494 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9197361110 | ||||||||
| FaxNumber: | 9197347570 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/11/2011 | ||||||||
| LastUpdateDate: | 05/04/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 05/04/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | MD-41195 | IA | N | Allopathic & Osteopathic Physicians | Internal Medicine | 208M00000X | 2014-01427 | NC | N | Allopathic & Osteopathic Physicians | Hospitalist | 390200000X | R-9206 | IA | N | Student, Health Care | Student in an Organized Health Care Education/Training Program | 207Q00000X | 2014-01427 | NC | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.