Provider Demographics
NPI:1891722245
Name:COPE, ROBERT MERRILL (MD)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:MERRILL
Last Name:COPE
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1490 E FOREMASTER DR
Mailing Address - Street 2:SUITE 300
Mailing Address - City:ST GEORGE
Mailing Address - State:UT
Mailing Address - Zip Code:84790-4488
Mailing Address - Country:US
Mailing Address - Phone:435-688-2104
Mailing Address - Fax:435-628-5308
Practice Address - Street 1:1490 E FOREMASTER DR
Practice Address - Street 2:SUITE 300
Practice Address - City:ST GEORGE
Practice Address - State:UT
Practice Address - Zip Code:84790-4488
Practice Address - Country:US
Practice Address - Phone:435-688-2104
Practice Address - Fax:435-628-5308
Is Sole Proprietor?:No
Enumeration Date:2006-06-28
Last Update Date:2007-11-29
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
UT1772961205208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT107006905102OtherSELECT HEALTH/IHC
UTQM0000039787OtherALTIUS
UT114556OtherANTHEM BLUE CROSS
UT340005827OtherRAIL ROAD MEDICARE
UT114556OtherANTHEM BLUE CROSS
UT000059708Medicare PIN