Provider Demographics
NPI:1386684462
Name:COPELAND, CAROL E (MD)
Entity Type:Individual
Prefix:
First Name:CAROL
Middle Name:E
Last Name:COPELAND
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 1:500 UNIVERSITY DR
Mailing Address - Street 2:BOX 850, H089
Mailing Address - City:HERSHEY
Mailing Address - State:PA
Mailing Address - Zip Code:17033-2360
Mailing Address - Country:US
Mailing Address - Phone:717-531-4803
Mailing Address - Fax:717-531-0498
Practice Address - Street 1:500 UNIVERSITY DR
Practice Address - Street 2:BOX 850, H089
Practice Address - City:HERSHEY
Practice Address - State:PA
Practice Address - Zip Code:17033-2360
Practice Address - Country:US
Practice Address - Phone:717-531-4803
Practice Address - Fax:717-531-0498
Is Sole Proprietor?:No
Enumeration Date:2006-06-07
Last Update Date:2010-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD40985207X00000X
MDD0040985207XX0801X
PAMD440074207XX0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XX0801XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Trauma
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD303311200Medicaid
MD1386684462OtherNPI
MD1386684462OtherNPI
MDE96639Medicare UPIN
MD839FMedicare PIN