Healthcare Provider Details

I. General information

NPI: 1922104124
Provider Name (Legal Business Name): LIMONE COLLINS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/15/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6900 GEORGIA AVE. BUILDING 41; SUITE 21
WASHINGTON DC
20012
US

IV. Provider business mailing address

2804 ANDER CT
BOWIE MD
20716-3835
US

V. Phone/Fax

Practice location:
  • Phone: 202-782-0411
  • Fax:
Mailing address:
  • Phone: 301-249-4546
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207K00000X
TaxonomyAllergy & Immunology Physician
License Number60240
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: