1922025956 NPI number — DR. SILVIA C MERIDA-COPELAND MD

Table of content: DR. SILVIA C MERIDA-COPELAND MD (NPI 1922025956)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1922025956 NPI number — DR. SILVIA C MERIDA-COPELAND MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MERIDA-COPELAND
Provider First Name:
SILVIA
Provider Middle Name:
C
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
MERIDA-OCHOA
Provider Other First Name:
SILVIA
Provider Other Middle Name:
CAROLINA
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1922025956
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/26/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
23 NORTH ST
Provider Second Line Business Mailing Address:
SUITE 1
Provider Business Mailing Address City Name:
PRESQUE ISLE
Provider Business Mailing Address State Name:
ME
Provider Business Mailing Address Postal Code:
04769-2291
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
207-768-4805
Provider Business Mailing Address Fax Number:
207-768-4003

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
23 NORTH ST
Provider Second Line Business Practice Location Address:
SUITE 1
Provider Business Practice Location Address City Name:
PRESQUE ISLE
Provider Business Practice Location Address State Name:
ME
Provider Business Practice Location Address Postal Code:
04769-2291
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
207-768-4805
Provider Business Practice Location Address Fax Number:
207-768-4003
Provider Enumeration Date:
07/16/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 2084P0800X , with the licence number:  017065 , registered in the state of ME ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 5266014 . This is a "AETNA HMO" identifier , issued by the state of ( ME ) . This identifiers is of the category "OTHER".
  • Identifier: AS OF 8/17/06 . This is a "BENEFIT SERVICES" identifier , issued by the state of ( ME ) . This identifiers is of the category "OTHER".
  • Identifier: AS OF 10/16/06 . This is a "UNITED HEALTHCARE" identifier , issued by the state of ( ME ) . This identifiers is of the category "OTHER".
  • Identifier: AS OF 12/5/06 . This is a "CIGNA" identifier , issued by the state of ( ME ) . This identifiers is of the category "OTHER".
  • Identifier: AS OF 12/5/06 . This is a "AETNA NON HMO" identifier , issued by the state of ( ME ) . This identifiers is of the category "OTHER".
  • Identifier: AS OF 8/10/06 . This is a "MARTINS POINT" identifier , issued by the state of ( ME ) . This identifiers is of the category "OTHER".
  • Identifier: 000027 . This is a "ANTHEM" identifier , issued by the state of ( ME ) . This identifiers is of the category "OTHER".




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