Cooley, Gerald

Cooley, Gerald is an sole proprietor health care provider with primary practice located at 10502 Park Rd Suite 100, Charlotte NC 28210-8479. He recently has only one registered license in Allopathic & Osteopathic Physicians / Dermatology, which is considered as his primary health care specialty. Cooley, Gerald can be contacted via phone (704) 542-1366.

Contact Information

Primary practice address
10502 Park Rd Suite 100 Charlotte NC 28210-8479
Phone: (704) 542-1366
Fax: (704) 542-1063
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Dermatology 207N00000X 9600496 North Carolina

Profile Details

NPI number 1679543300
LBN Legal business name Cooley, Gerald
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jan 25th, 2006
Last updated May 1st, 2008 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1679543300 NPPES
North Carolina Other 562078587 TAX ID
North Carolina Other 0212C TAX ID

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