Provider Demographics
NPI:1467008383
Name:COOPERMAN, STEVEN (DPM)
Entity type:Individual
Prefix:
First Name:STEVEN
Middle Name:
Last Name:COOPERMAN
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:163 TOWER CIR
Mailing Address - Street 2:
Mailing Address - City:SOMERSET
Mailing Address - State:KY
Mailing Address - Zip Code:42503-3479
Mailing Address - Country:US
Mailing Address - Phone:606-679-7464
Mailing Address - Fax:606-678-8586
Practice Address - Street 1:350 W WILSON BRIDGE RD STE 200
Practice Address - Street 2:
Practice Address - City:WORTHINGTON
Practice Address - State:OH
Practice Address - Zip Code:43085-2591
Practice Address - Country:US
Practice Address - Phone:614-885-8747
Practice Address - Fax:614-895-8810
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-15
Last Update Date:2025-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH36.004089213E00000X, 213ES0103X
390200000X
KY293858213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
No213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY293858OtherKY MEDICAL LICENSE
OH0022994Medicaid