Healthcare Provider Details

I. General information

NPI: 1174884225
Provider Name (Legal Business Name): ANNA COLLINS SALIB M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ANNA CATHERINE COLLINS

II. Dates (important events)

Enumeration Date: 06/05/2012
Last Update Date: 01/21/2022
Certification Date: 01/21/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3129 SPRINGBANK LN STE 100
CHARLOTTE NC
28226-3379
US

IV. Provider business mailing address

PO BOX 60447
CHARLOTTE NC
28260-0447
US

V. Phone/Fax

Practice location:
  • Phone: 704-384-5151
  • Fax: 704-316-2905
Mailing address:
  • Phone: 844-266-8268
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberMD34735
License Number StateSC
# 2
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number2015-01295
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: