Healthcare Provider Details
I. General information
NPI: 1679584841
Provider Name (Legal Business Name): VIRGINIA UPCHURCH COLLIER M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 08/11/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
CHRISTIANA HOSPITAL 4755 OGLETOWN STANTON ROAD
NEWARK DE
19718-0002
US
IV. Provider business mailing address
CHRISTIANA HOSPITAL 4755 OGLETOWN STANTON ROAD
NEWARK DE
19718-0002
US
V. Phone/Fax
- Phone: 302-733-6343
- Fax: 302-733-6378
- Phone: 302-733-6343
- Fax: 302-733-6378
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207RN0300X |
| Taxonomy | Nephrology Physician |
| License Number | C1-0003208 |
| License Number State | DE |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: