Individual
SHAINA KOPELOV
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
701 E MAIN ST, CLARKSBURG, WV 26301-3225
(304) 624-0161
Mailing address
102 WESTWOOD AVE, BRIDGEPORT, WV 26330-1036
(304) 613-9310
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
RP0012232
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
RP0012232
WV BOARD OF PHARMACY
WV
Enumeration date
09/29/2020
Last updated
09/29/2020
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