Provider Demographics
NPI:1053344069
Name:COPE, DARRELL A (MD)
Entity type:Individual
Prefix:
First Name:DARRELL
Middle Name:A
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 1:624 QUAKER LN
Mailing Address - Street 2:STE. 207C
Mailing Address - City:HIGH POINT
Mailing Address - State:NC
Mailing Address - Zip Code:27262-3832
Mailing Address - Country:US
Mailing Address - Phone:336-883-2500
Mailing Address - Fax:
Practice Address - Street 1:400 N ELM ST
Practice Address - Street 2:
Practice Address - City:HIGH POINT
Practice Address - State:NC
Practice Address - Zip Code:27262-4939
Practice Address - Country:US
Practice Address - Phone:336-878-6530
Practice Address - Fax:336-878-6531
Is Sole Proprietor?:No
Enumeration Date:2006-07-10
Last Update Date:2016-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC9400226207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC160029942OtherRAILROAD MEDICARE
NC8924219Medicaid
NC160029942OtherRAILROAD MEDICARE
NCNCF729BMedicare PIN