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General NPI Number Information
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NPI Number | 1629210224
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Entity Type | Organization
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Legal Business Name | DREW V COLLINS MD PC
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Dates
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Enumeration Date | 03/27/2009
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Last Update Date | 08/22/2011
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Provider Practice Location Address
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Address Line | 1104 CASS ST
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City | TRAVERSE CITY
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State | MI
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Zip | 49684-3236
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Country | US
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Telephone | 231-946-2214
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Fax | 231-941-1347
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Provider Business Mailing Address
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Address Line | 1104 CASS ST
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City | TRAVERSE CITY
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State | MI
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Zip | 49684-3236
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Country | US
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Telephone | 231-946-2214
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Fax | 231-941-1347
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Authorized Official
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Title or Position | PHYSICIAN/OWNER
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Name | DR. DREW V. COLLINS
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Credential | M.D.
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Telephone | 231-946-2214
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 4301079612
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License Number State | MI
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