Provider Demographics
NPI:1801036090
Name:CENTER FOR HEALTH PLLC
Entity Type:Organization
Organization Name:CENTER FOR HEALTH PLLC
Other - Org Name:SAM P COPELAND DO
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SAM
Authorized Official - Middle Name:P
Authorized Official - Last Name:COPELAND
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:231-929-2900
Mailing Address - Street 1:615 E 8TH ST
Mailing Address - Street 2:
Mailing Address - City:TRAVERSE CITY
Mailing Address - State:MI
Mailing Address - Zip Code:49686-2630
Mailing Address - Country:US
Mailing Address - Phone:231-929-2900
Mailing Address - Fax:231-929-7191
Practice Address - Street 1:615 E EIGHTH ST
Practice Address - Street 2:
Practice Address - City:TRAVERSE CITY
Practice Address - State:MI
Practice Address - Zip Code:49686-2630
Practice Address - Country:US
Practice Address - Phone:231-929-2900
Practice Address - Fax:231-929-7191
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-27
Last Update Date:2022-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5151008468204D00000X
204D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes204D00000XAllopathic & Osteopathic PhysiciansNeuromusculoskeletal Medicine & OMMGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI010B813750OtherBCBSM
MI5283081Medicare PIN
MI010B813750OtherBCBSM