| Ms Amanda Nicole Cooper, MD | |
|
N112w15415 Mequon Rd, Germantown, WI 53022-3410 | |
| (262) 255-2112 | |
| (262) 255-6533 |
| Full Name | Ms Amanda Nicole Cooper |
|---|---|
| Gender | Female |
| Speciality | Dermatology |
| Experience | 16 Years |
| Location | N112w15415 Mequon Rd, Germantown, Wisconsin |
| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1588808562 | NPI | - | NPPES |
| 1588808562 | Medicaid | WI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207N00000X | Dermatology | 63620 (Wisconsin) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Ascension Columbia St Mary's Hospital Milwaukee | Milwaukee, WI | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Madison Medical Affiliates Inc | 5991606337 | 83 |
| Entity Name | Columbia St Marys Hospital Milwaukee Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1023064482 PECOS PAC ID: 5890604722 Enrollment ID: O20031105000057 |
| Entity Name | Madison Medical Affiliates Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1588695746 PECOS PAC ID: 5991606337 Enrollment ID: O20040119000018 |
| Mailing Address | Practice Location Address |
|---|---|
| Ms Amanda Nicole Cooper, MD 788 N Jefferson St, Suite 300/attn. Kaaren Butzen, Milwaukee, WI 53202-3718 Ph: (414) 272-8950 | Ms Amanda Nicole Cooper, MD N112w15415 Mequon Rd, Germantown, WI 53022-3410 Ph: (262) 255-2112 |
Marianne M Junck, Dermatology Medicare: Accepting Medicare Assignments Practice Location: N112w17975 Mequon Rd, Germantown, WI 53022 Phone: 262-532-7600 | |
Beth A Schenck, MD Dermatology Medicare: Not Enrolled in Medicare Practice Location: N112w15415 Mequon Rd, Germantown, WI 53022 Phone: 262-255-2112 Fax: 262-255-6533 |