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Cooper Blazek, MD
Student in an Organized Health Care Education/Training Program in Monroe, North Carolina
NPI 1659013340

Cooper Blazek is a Student in an Organized Health Care Education/Training Program based in Winston Salem, NC. Cooper Blazek practices in Monroe, NC and has the professional credentials of MD. The NPI Number for Cooper Blazek is 1659013340 and holds a License No. (North Carolina).

The current practice location address for Cooper Blazek is 1106 Reynolds St Ste 100, Monroe, NC and can be reached out via phone at 704-289-5443.

Location: 1106 Reynolds St Ste 100, Monroe, NC, 27106
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1659013340
Provider Name
Cooper Blazek
Credential
MD
Provider Entity Type
Individual
Gender
Male
Address
1106 Reynolds St Ste 100, Monroe, NC, 27106
Phone Number
704-289-5443
Fax Number
Provider Enumeration Date
04/12/2022
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
1106 Reynolds St Ste 100
City
Monroe
State
North Carolina
Zip
28112-4376
Phone Number
704-289-5443
Fax Number
person
Provider Business Mailing Address Details
Address
1106 Reynolds St Ste 100
City
Monroe
State
North Carolina
Zip
28112-4376
Phone Number
704-289-5443
Fax Number
person
Provider's Taxonomy Details 1
Type
Student, Health Care
Classification
Student in an Organized Health Care Education/Training Program
Speciality
-
Taxonomy
390200000X
License No.
(North Carolina)
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
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