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Individual
DR. GREGORY W COPPOLA
Active
Individual
DR. GREGORY W COPPOLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Taxonomy
Speciality
Code
Description
License number
State
204D00000X
Neuromusculoskeletal Medicine & OMM Physician
Primary
OS010713L
PA
207QS0010X
Sports Medicine (Family Medicine) Physician
OS010713L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0018041330009
—
PA
05
—
0018041330011
—
PA
Enumeration date
01/10/2006
Last updated
01/04/2017
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