Provider Demographics
NPI:1659573525
Name:COPELAND, BRIAN
Entity Type:Individual
Prefix:
First Name:BRIAN
Middle Name:
Last Name:COPELAND
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:ONE MEDICAL CENTER BLVD
Mailing Address - Street 2:SUITE 231
Mailing Address - City:UPLAND
Mailing Address - State:PA
Mailing Address - Zip Code:19013-3902
Mailing Address - Country:US
Mailing Address - Phone:610-619-7475
Mailing Address - Fax:610-619-7477
Practice Address - Street 1:ONE MEDICAL CENTER BLVD
Practice Address - Street 2:SUITE 231
Practice Address - City:UPLAND
Practice Address - State:PA
Practice Address - Zip Code:19013-3902
Practice Address - Country:US
Practice Address - Phone:610-619-7475
Practice Address - Fax:610-619-7477
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-04
Last Update Date:2013-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS012822207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine