Provider Demographics
NPI:1477637239
Name:KUCEWICZ KOPYTA, BARBARA ELZBIETA (MD)
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:ELZBIETA
Last Name:KUCEWICZ KOPYTA
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 1:312 SAND MOUNTAIN DRIVE SOUTHEAST
Mailing Address - Street 2:
Mailing Address - City:ALBERTVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35950
Mailing Address - Country:US
Mailing Address - Phone:256-891-4577
Mailing Address - Fax:256-891-4919
Practice Address - Street 1:312 SAND MOUNTAIN DRIVE SOUTHEAST
Practice Address - Street 2:
Practice Address - City:ALBERTVILLE
Practice Address - State:AL
Practice Address - Zip Code:35950
Practice Address - Country:US
Practice Address - Phone:256-891-4577
Practice Address - Fax:256-891-4919
Is Sole Proprietor?:No
Enumeration Date:2006-10-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL00021174207R00000X
PAMD062147L207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL009951470Medicaid
AL051501031OtherBCBS
AL051501031OtherBCBS
G61099Medicare UPIN