Provider Demographics
NPI:1093886111
Name:KOPELMAN, ALISON H (MD)
Entity Type:Individual
Prefix:
First Name:ALISON
Middle Name:H
Last Name:KOPELMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 MEDICAL CENTER DR
Mailing Address - Street 2:
Mailing Address - City:BIDDEFORD
Mailing Address - State:ME
Mailing Address - Zip Code:04005-9422
Mailing Address - Country:US
Mailing Address - Phone:207-282-9080
Mailing Address - Fax:207-284-6271
Practice Address - Street 1:655 MAIN ST
Practice Address - Street 2:
Practice Address - City:SACO
Practice Address - State:ME
Practice Address - Zip Code:04072-1543
Practice Address - Country:US
Practice Address - Phone:207-294-5959
Practice Address - Fax:207-284-6291
Is Sole Proprietor?:No
Enumeration Date:2006-11-11
Last Update Date:2013-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEMD17581208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME1093886111OtherANTHEM
ME1093886111Medicaid
ME6141753OtherCIGNA/GREATWEST
AA126422OtherHARVARD PILGRIM HEALTHCARE
ME1093886111OtherANTHEM