# DR. CAROL ANNE BORACK COPENHAVER

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1205882370
- **Gender:** F
- **Credential:** MD

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 2009-00967 | NC | Yes |

## Other

- **Enumeration date:** 05/26/2006
- **Last updated:** 04/26/2023

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 1646946 | HIGHMARK PA BLUE SHIELD | PA |
| 01 | — | NNP232N787 | MEDICARE PTAN | NC |
| 01 | — | P00322251 | PALMETTO RR | PA |
| 01 | — | P01169433 | RR MEDICARE | NC |