Provider Demographics
NPI:1588699375
Name:COOPER, BRAD J (MD)
Entity type:Individual
Prefix:DR
First Name:BRAD
Middle Name:J
Last Name:COOPER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:3421 CONCORD RD
Mailing Address - Street 2:SUITE B3
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17402-9001
Mailing Address - Country:US
Mailing Address - Phone:717-851-1405
Mailing Address - Fax:301-271-2650
Practice Address - Street 1:52 WATER ST
Practice Address - Street 2:
Practice Address - City:THURMONT
Practice Address - State:MD
Practice Address - Zip Code:21788-1912
Practice Address - Country:US
Practice Address - Phone:301-271-3535
Practice Address - Fax:301-271-2650
Is Sole Proprietor?:No
Enumeration Date:2006-07-11
Last Update Date:2019-02-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMD050724L207Q00000X
MDD0022819207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA02244702OtherCAPITAL BLUE CROSS-WMG
PA107284OtherUNISON-WMG
MD153251100Medicaid
PA20013087OtherAMERIHEALTH MERCY-WMG
PA2101377OtherMAMSI-WMG
MD307700OtherCAREFIRST MD BCBS
PA35172OtherGEISINGER
PA37475OtherJOHNS HOPKINS
PA4106017OtherAETNA
PAP003004OtherGATEWAY-WMG
PA691655OtherHIGHMARK BLUE SHIELD
PA001453216Medicaid
MD462M692FMedicare PIN
PA35172OtherGEISINGER
PA2101377OtherMAMSI-WMG
PA02244702OtherCAPITAL BLUE CROSS-WMG