Provider Demographics
NPI:1316971773
Name:COOPER, ROBERT M (MD)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:M
Last Name:COOPER
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:190 E BANNOCK ST
Mailing Address - Street 2:HOSPITALIST OFFICE 2ND FLOOR
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83712
Mailing Address - Country:US
Mailing Address - Phone:208-381-4166
Mailing Address - Fax:208-381-3681
Practice Address - Street 1:190 E BANNOCK ST
Practice Address - Street 2:
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83712-6241
Practice Address - Country:US
Practice Address - Phone:208-381-4166
Practice Address - Fax:208-381-3681
Is Sole Proprietor?:No
Enumeration Date:2006-07-10
Last Update Date:2011-11-09
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IDM10060208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist