Healthcare Provider Details

I. General information

NPI: 1992182794
Provider Name (Legal Business Name): COLLIN R. OHNING
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/30/2015
Last Update Date: 01/08/2020
Certification Date: 01/08/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7501 GREENWAY CENTER DR # 300
GREENBELT MD
20770-3514
US

IV. Provider business mailing address

660 PENNSYLVANIA AVE SE STE 200
WASHINGTON DC
20003-4361
US

V. Phone/Fax

Practice location:
  • Phone: 301-474-4679
  • Fax: 301-474-7182
Mailing address:
  • Phone: 202-331-1188
  • Fax: 301-474-7182

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207WX0107X
TaxonomyRetina Specialist (Ophthalmology) Physician
License NumberMD046964
License Number StateDC
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberTRN22040
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License NumberMD046964
License Number StateDC
# 4
Primary TaxonomyN
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License NumberD0087357
License Number StateMD
# 5
Primary TaxonomyN
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number0101266781
License Number StateVA
# 6
Primary TaxonomyN
Taxonomy Code207WX0107X
TaxonomyRetina Specialist (Ophthalmology) Physician
License Number0101266781
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: