Provider Demographics
NPI:1386623726
Name:COPELAND, MICHAEL L (MD PHD)
Entity type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:L
Last Name:COPELAND
Suffix:
Gender:M
Credentials:MD PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1041 N 29TH ST
Mailing Address - Street 2:
Mailing Address - City:BILLINGS
Mailing Address - State:MT
Mailing Address - Zip Code:59101-0731
Mailing Address - Country:US
Mailing Address - Phone:406-237-5577
Mailing Address - Fax:406-237-5575
Practice Address - Street 1:1041 N 29TH ST
Practice Address - Street 2:
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59101-0731
Practice Address - Country:US
Practice Address - Phone:406-237-5577
Practice Address - Fax:406-237-5575
Is Sole Proprietor?:No
Enumeration Date:2006-01-13
Last Update Date:2022-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY7072A207T00000X
MT10483207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
WY119057100Medicaid
MT0144391Medicaid
G26729Medicare UPIN