Provider Demographics
NPI:1114034857
Name:COPAS, CHERYL A (MD)
Entity Type:Individual
Prefix:DR
First Name:CHERYL
Middle Name:A
Last Name:COPAS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:1550 JANMAR RD # B
Mailing Address - Street 2:
Mailing Address - City:SNELLVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30078-5600
Mailing Address - Country:US
Mailing Address - Phone:770-979-9331
Mailing Address - Fax:770-979-8827
Practice Address - Street 1:1550 JANMAR RD # B
Practice Address - Street 2:
Practice Address - City:SNELLVILLE
Practice Address - State:GA
Practice Address - Zip Code:30078-5600
Practice Address - Country:US
Practice Address - Phone:770-979-9331
Practice Address - Fax:770-979-8827
Is Sole Proprietor?:No
Enumeration Date:2006-08-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GA27361207Q00000X
KY22907207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA0005370286OtherAETNA
GA002077OtherBCBS
GA0101777OtherUNITED HEALTHCARE
GA002077OtherBCBS
GA08BBRPCMedicare ID - Type Unspecified