Healthcare Provider Details

I. General information

NPI: 1023208295
Provider Name (Legal Business Name): MARGARET A COLLINS M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/25/2007
Last Update Date: 10/02/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3555 WILLOW LAKE BLVD SUITE 240
VADNAIS HEIGHTS MN
55110-5131
US

IV. Provider business mailing address

3555 WILLOW LAKE BLVD SUITE 240
SAINT PAUL MN
55110-5131
US

V. Phone/Fax

Practice location:
  • Phone: 651-770-0110
  • Fax: 651-770-0134
Mailing address:
  • Phone: 651-770-0110
  • Fax: 651-770-0134

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number52763
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: