Provider Demographics
NPI:1386089126
Name:COPE, MYLES NATHANIEL (MD)
Entity type:Individual
Prefix:DR
First Name:MYLES
Middle Name:NATHANIEL
Last Name:COPE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2101 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:LONGMONT
Mailing Address - State:CO
Mailing Address - Zip Code:80501-1406
Mailing Address - Country:US
Mailing Address - Phone:970-237-8031
Mailing Address - Fax:970-237-8035
Practice Address - Street 1:2101 MAIN ST
Practice Address - Street 2:
Practice Address - City:LONGMONT
Practice Address - State:CO
Practice Address - Zip Code:80501-1406
Practice Address - Country:US
Practice Address - Phone:970-237-8031
Practice Address - Fax:970-237-8035
Is Sole Proprietor?:No
Enumeration Date:2013-05-07
Last Update Date:2022-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CODR.00637022083X0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083X0100XAllopathic & Osteopathic PhysiciansPreventive MedicineOccupational Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO9000203790Medicaid