Healthcare Provider Details

I. General information

NPI: 1154064459
Provider Name (Legal Business Name): STEVEN ISAMU COLLINS DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/15/2022
Last Update Date: 10/08/2025
Certification Date: 10/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1900 N HIGLEY ROAD ATTN BMG HOSPITALIST TEAM/AMANDA GUMP
GILBERT AZ
85234
US

IV. Provider business mailing address

1900 N HIGLEY ROAD ATTN BMG HOSPITALIST TEAM/AMANDA GUMP
GILBERT AZ
85234
US

V. Phone/Fax

Practice location:
  • Phone: 480-543-2034
  • Fax: 480-543-2647
Mailing address:
  • Phone: 480-543-2034
  • Fax: 480-543-2647

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number011789
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberPG211304
License Number StateOR
# 3
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License NumberDO223662
License Number StateOR
# 4
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number011789
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: