Provider Demographics
NPI:1629176227
Name:COPF, REBECCA M (MD)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:M
Last Name:COPF
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:67330 PASCHALK RD
Mailing Address - Street 2:
Mailing Address - City:LENOX
Mailing Address - State:MI
Mailing Address - Zip Code:48050-1347
Mailing Address - Country:US
Mailing Address - Phone:586-727-3038
Mailing Address - Fax:586-727-3038
Practice Address - Street 1:67330 PASCHALK RD
Practice Address - Street 2:
Practice Address - City:LENOX
Practice Address - State:MI
Practice Address - Zip Code:48050-1347
Practice Address - Country:US
Practice Address - Phone:586-727-3038
Practice Address - Fax:586-727-3038
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2021-07-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MIRC071894207R00000X
MI4301068022207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0H24845OtherBCBS MI
MI4930419-10Medicaid
MI4930419-10Medicaid
MIH33520Medicare UPIN