Individual
MICHAEL PATRICK COPPOLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
801 CROMWELL PARK DR, SUITE 108, GLEN BURNIE, MD 21061-2539
(410) 590-0443
(410) 590-4403
Mailing address
801 CROMWELL PARK DR, SUITE 108, GLEN BURNIE, MD 21061-2539
(410) 590-0443
(410) 590-4403
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
D74925
MD
207RS0012X
Sleep Medicine (Internal Medicine) Physician
Primary
D74925
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
054100
TUFTS HEALTH PLAN
MA
01
—
11550
HEALTH NEW ENGLAND
MA
05
—
6193374
—
MA
01
—
J04196
BLUE CROSS BLUE SHIELD
MA
Enumeration date
06/05/2006
Last updated
07/09/2013
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