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NPI Code Detail

MEDICARE: DR. MARK W. COLLAR M.D.

MEDICARE: DR. MARK W. COLLAR M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207L00000XAnesthesiology Physician38554WI

General Provider Information

NPI Number : 1659354553
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MARK W. COLLAR M.D.
Provider Business Mailing Address
First Line : 515 22ND AVE
Second Line :
City : MONROE
State : WI
Zip : 53566-1569
Country : US
Telephone Number : 715-361-2000
Fax Number :
Provider Business Practice Location Address
First Line : 515 22ND AVE
Second Line : MONROE CLINIC
City : MONROE
State : WI
Zip : 53566-1569
Country : US
Telephone Number : 608-324-2222
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/23/2005
Last Update Date : 02/21/2017

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Directions to “ DR. MARK W. COLLAR M.D.” Practice Location

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