Individual
CARY LEWIS COPELAND
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.P.M.
Contact information
Practice address
4260 GLENDALE MILFORD RD, SUITE 103, BLUE ASH, OH 45242-3704
(513) 769-4408
(513) 769-4578
Mailing address
PO BOX 322, BATAVIA, OH 45103-0322
(513) 474-1906
(513) 474-9272
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
36-002638
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000250229
ANTHEM
OH
05
—
0908058
—
OH
01
—
480034608
RR MEDICARE
OH
Enumeration date
12/07/2005
Last updated
10/16/2014
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