Individual
BOHDAN WILLIAM KOPYNEC
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
112 E BALLARD ST, ELLERBE, NC 28338-9730
(910) 652-2633
(910) 652-3150
Mailing address
PO BOX 843013, BOSTON, MA 02284-3013
(910) 652-2663
(910) 652-3150
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
9901427
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1236E
BCBS
NC
01
—
6120496002
CIGNA PAL
—
01
—
7802441
AETNA
—
05
—
891236E
—
NC
01
—
FH1000880
FIRST CAROLINA CARE
—
05
—
Q0142C
—
SC
Enumeration date
09/14/2005
Last updated
10/22/2014
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