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CHAD MICHAEL COPPER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
725 JESSE JEWELL PKWY SE, GAINESVILLE, GA 30501-3834
(770) 536-2323
(770) 536-4947
Mailing address
PO BOX 658, GAINESVILLE, GA 30503-0658
(770) 718-1122
(770) 535-7445

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
055818
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
10045077
AMERIGROUP
GA
01
2548303
UNITED HEALTHCARE
GA
01
340827
WELLCARE
GA
01
52170731
BCBS
GA
05
603854369A
GA
05
603854369B
GA
01
7385826
AETNA
GA
01
8411488
CIGNA
GA
01
P00246474
RR MEDICARE-GRP # CC4177
GA
Enumeration date
01/18/2006
Last updated
05/22/2024
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