Individual
DR. JOHN HARRISON KOPCHICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2240 TEAL CT SE, GRAND RAPIDS, MI 49546-7939
(616) 635-1220
Mailing address
2240 TEAL CT SE, GRAND RAPIDS, MI 49546-7939
(616) 635-1220
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
4301043886
MI
208800000X
Urology Physician
58797
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
104135289
—
MI
01
—
3404100631
BLUE CROSS BLUE SHIELD
MI
01
—
900002217
PRIORITY HEALTH
MI
Enumeration date
06/16/2006
Last updated
03/17/2018
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