=====================================================
General NPI Number Information
=====================================================
NPI Number | 1700067691
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | MARGARITA COLLINS MD PC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/19/2007
-----------------------------------------------------
Last Update Date | 12/14/2010
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 963 OAKWOOD DR
-----------------------------------------------------
City | ROCHESTER
-----------------------------------------------------
State | MI
-----------------------------------------------------
Zip | 48307-1318
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 248-656-1166
-----------------------------------------------------
Fax | 248-656-1788
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 963 OAKWOOD DR
-----------------------------------------------------
City | ROCHESTER
-----------------------------------------------------
State | MI
-----------------------------------------------------
Zip | 48307-1318
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 248-656-1166
-----------------------------------------------------
Fax | 248-656-1788
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | MARGARITA COLLINS
-----------------------------------------------------
Credential | M .D.
-----------------------------------------------------
Telephone | 248-656-1166
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207RH0003X
-----------------------------------------------------
Taxonomy Name | Hematology & Oncology Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------