Provider Demographics
NPI:1750575817
Name:BRIAN R COPELAND MD PC
Entity type:Organization
Organization Name:BRIAN R COPELAND MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:R
Authorized Official - Last Name:COPELAND
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:989-839-3235
Mailing Address - Street 1:4011 ORCHARD DR
Mailing Address - Street 2:SUITE 4004
Mailing Address - City:MIDLAND
Mailing Address - State:MI
Mailing Address - Zip Code:48640-6190
Mailing Address - Country:US
Mailing Address - Phone:989-839-3235
Mailing Address - Fax:
Practice Address - Street 1:4011 ORCHARD DR
Practice Address - Street 2:SUITE 4004
Practice Address - City:MIDLAND
Practice Address - State:MI
Practice Address - Zip Code:48640-6190
Practice Address - Country:US
Practice Address - Phone:989-839-3235
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-31
Last Update Date:2007-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIBC076460174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty