Provider Demographics
NPI:1548328420
Name:COPELAND, DONALD LEE SR (MD)
Entity type:Individual
Prefix:DR
First Name:DONALD
Middle Name:LEE
Last Name:COPELAND
Suffix:SR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:151 SIGMON RD
Mailing Address - Street 2:
Mailing Address - City:LINCOLNTON
Mailing Address - State:NC
Mailing Address - Zip Code:28092-8577
Mailing Address - Country:US
Mailing Address - Phone:704-735-3001
Mailing Address - Fax:704-736-8843
Practice Address - Street 1:151 SIGMON RD
Practice Address - Street 2:
Practice Address - City:LINCOLNTON
Practice Address - State:NC
Practice Address - Zip Code:28092-8577
Practice Address - Country:US
Practice Address - Phone:704-735-3001
Practice Address - Fax:704-736-8843
Is Sole Proprietor?:No
Enumeration Date:2006-12-04
Last Update Date:2010-07-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC13776207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC89-24215Medicaid
NC89-24215Medicaid
NC201149KMedicare ID - Type Unspecified