Individual
MRS. MARY ELLEN COPENING
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A
Contact information
Practice address
18 OLD ETNA RD, DH - INTERNAL MEDICINE, LEBANON, NH 03766
(603) 650-4000
(603) 650-4190
Mailing address
1 MEDICAL CENTER DR, DHMC - GIM, LEBANON, NH 03756-1000
(603) 650-4000
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0148
NH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0AP0777
—
VT
05
—
30010001
—
NH
Enumeration date
07/05/2006
Last updated
12/27/2012
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