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General NPI Number Information
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NPI Number | 1538461629
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Entity Type | Organization
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Legal Business Name | MICHELLE COPELAND DMD MD PC
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Dates
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Enumeration Date | 11/23/2010
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Last Update Date | 07/20/2023
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Provider Practice Location Address
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Address Line | 1001 5TH AVE
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City | NEW YORK
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State | NY
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Zip | 10028-0107
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Country | US
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Telephone | 212-452-2200
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Fax | 212-452-2208
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Provider Business Mailing Address
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Address Line | 1001 5TH AVE
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City | NEW YORK
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State | NY
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Zip | 10028-0107
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Country | US
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Telephone | 212-452-2200
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Fax | 212-452-2208
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. MICHELLE COPELAND
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Credential | D.M.D., M.D.
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Telephone | 212-452-2200
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208200000X
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Taxonomy Name | Plastic Surgery Physician
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License Number | 147955-1
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License Number State | NY
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