Provider Demographics
NPI:1679602957
Name:COOPER, EMILY HAYNES (MD)
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:HAYNES
Last Name:COOPER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:4258 NC HIGHWAY 49 S UNIT 400
Mailing Address - Street 2:
Mailing Address - City:HARRISBURG
Mailing Address - State:NC
Mailing Address - Zip Code:28075-0107
Mailing Address - Country:US
Mailing Address - Phone:704-796-0899
Mailing Address - Fax:804-999-0502
Practice Address - Street 1:10310 MALLARD CREEK RD STE 101-D
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28262-4563
Practice Address - Country:US
Practice Address - Phone:704-796-0899
Practice Address - Fax:804-999-0502
Is Sole Proprietor?:No
Enumeration Date:2007-03-05
Last Update Date:2024-09-23
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NC2014-02177207Q00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine