Healthcare Provider Details

I. General information

NPI: 1184037053
Provider Name (Legal Business Name): DANIEL KOPOLOVICH MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/08/2014
Last Update Date: 06/12/2025
Certification Date: 06/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5900 CORPORATE DR STE 200
PITTSBURGH PA
15237-7005
US

IV. Provider business mailing address

5900 CORPORATE DR STE 200
PITTSBURGH PA
15237-7005
US

V. Phone/Fax

Practice location:
  • Phone: 412-369-4000
  • Fax: 412-369-7667
Mailing address:
  • Phone: 412-369-4000
  • Fax: 412-369-7667

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberMD484834
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: