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General NPI Number Information
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NPI Number | 1750575817
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Entity Type | Organization
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Legal Business Name | BRIAN R COPELAND MD PC
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Dates
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Enumeration Date | 08/31/2007
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Last Update Date | 08/31/2007
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Provider Practice Location Address
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Address Line | 4011 ORCHARD DR SUITE 4004
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City | MIDLAND
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State | MI
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Zip | 48640-6190
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Country | US
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Telephone | 989-839-3235
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Fax |
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Provider Business Mailing Address
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Address Line | 4011 ORCHARD DR SUITE 4004
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City | MIDLAND
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State | MI
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Zip | 48640-6190
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Country | US
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Telephone | 989-839-3235
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Fax |
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Authorized Official
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Title or Position | MEDICAL DOCTOR
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Name | DR. BRIAN R COPELAND
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Credential | M.D.
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Telephone | 989-839-3235
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | BC076460
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License Number State | MI
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