Provider Demographics
NPI:1184609307
Name:COPELAND, MAURA PEPOSE (MD)
Entity type:Individual
Prefix:DR
First Name:MAURA
Middle Name:PEPOSE
Last Name:COPELAND
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:PO BOX 9142
Mailing Address - Street 2:MASS GENERAL PHYSICIAN ORGANIZATION
Mailing Address - City:CHARLESTOWN
Mailing Address - State:MA
Mailing Address - Zip Code:02129-9142
Mailing Address - Country:US
Mailing Address - Phone:617-724-0287
Mailing Address - Fax:617-726-2894
Practice Address - Street 1:55 FRUIT STREET
Practice Address - Street 2:149-9124 MASSACHUSETTS GENERAL HOSPITAL
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02114
Practice Address - Country:US
Practice Address - Phone:617-726-5571
Practice Address - Fax:617-726-5760
Is Sole Proprietor?:No
Enumeration Date:2005-12-09
Last Update Date:2016-02-10
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Provider Licenses
StateLicense IDTaxonomies
MA764142084P0800X, 2084P0805X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0805XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyGeriatric Psychiatry
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
F73530Medicare UPIN
MAJ14415Medicare ID - Type Unspecified