Provider Demographics
NPI:1386617025
Name:COOPER, ANN C (MD)
Entity type:Individual
Prefix:
First Name:ANN
Middle Name:C
Last Name:COOPER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3241 WESTERN BRANCH BLVD
Mailing Address - Street 2:
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23321-5260
Mailing Address - Country:US
Mailing Address - Phone:757-686-3508
Mailing Address - Fax:757-686-0541
Practice Address - Street 1:2088 S INDEPENDENCE BLVD
Practice Address - Street 2:STE 103
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23453-4790
Practice Address - Country:US
Practice Address - Phone:757-275-9331
Practice Address - Fax:757-416-7656
Is Sole Proprietor?:No
Enumeration Date:2006-02-13
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101055731207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA237636OtherANTHEM
VA541595397OtherTRICARE
VA541595397OtherVIRGINIA HEALTH NETWORK
VA22149OtherSENTARA/OPTIMA
VA541595397OtherMID ATLANTIC SOLUTIONS
VA541595397OtherCIGNA
VA541595397OtherPRIVATE HEALTHCARE SYSTEM
VA2321988OtherAETNA
VA22149OtherSENTARA/OPTIMA
VA541595397OtherCIGNA