Provider Demographics
NPI:1982254454
Name:COPLEY, MAXIME V
Entity Type:Individual
Prefix:MS
First Name:MAXIME
Middle Name:V
Last Name:COPLEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PSC 2 BOX 15619
Mailing Address - Street 2:
Mailing Address - City:APO
Mailing Address - State:AE
Mailing Address - Zip Code:09012-0157
Mailing Address - Country:US
Mailing Address - Phone:863-253-1440
Mailing Address - Fax:
Practice Address - Street 1:FLUGPLATZ BLDG 2121
Practice Address - Street 2:
Practice Address - City:RAMSTEIN-MIESENBACH
Practice Address - State:RAMSTEIN
Practice Address - Zip Code:66877
Practice Address - Country:DE
Practice Address - Phone:063-714-6227
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-09-17
Last Update Date:2019-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1710I1003XOther Service ProvidersMilitary Health Care ProviderIndependent Duty Medical Technicians