Provider Demographics
NPI:1649164005
Name:COPELAND, WALTER EARL II (DMSC)
Entity type:Individual
Prefix:DR
First Name:WALTER
Middle Name:EARL
Last Name:COPELAND
Suffix:II
Gender:M
Credentials:DMSC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 223
Mailing Address - Street 2:
Mailing Address - City:GLENSIDE
Mailing Address - State:PA
Mailing Address - Zip Code:19038-0223
Mailing Address - Country:US
Mailing Address - Phone:570-689-8371
Mailing Address - Fax:
Practice Address - Street 1:PO BOX 223
Practice Address - Street 2:
Practice Address - City:GLENSIDE
Practice Address - State:PA
Practice Address - Zip Code:19038-0223
Practice Address - Country:US
Practice Address - Phone:570-689-8371
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-09
Last Update Date:2025-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133N00000XDietary & Nutritional Service ProvidersNutritionist