MEDICARE: NANCY E. COPELAND M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174400000X	Specialist	D0060569	MD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1508843152
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NANCY E. COPELAND M.D.

Provider Business Mailing Address
First Line	:	20400 OBSERVATION DR
Second Line	:	SUITE 205
City	:	GERMANTOWN
State	:	MD
Zip	:	20876-4085
Country	:	US
Telephone Number	:	301-972-9559
Fax Number	:	301-972-9593

Provider Business Practice Location Address
First Line	:	20400 OBSERVATION DR
Second Line	:	SUITE 205
City	:	GERMANTOWN
State	:	MD
Zip	:	20876-4085
Country	:	US
Telephone Number	:	301-972-9559
Fax Number	:	301-972-9593

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/26/2005
Last Update Date	:	04/30/2013

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