MEDICARE: DR. MARGARET A COLLINS M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207N00000X	Dermatology Physician	52763	MN

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	070001053	OTHER	MN	MEDICARE PTAN
3	P01199763	OTHER	MN	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	8GJ79CO	OTHER	MN	BLUE SHIELD
4	00030001117	OTHER	MN	MEDICA

General Provider Information

NPI Number	:	1023208295
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MARGARET A COLLINS M.D.

Provider Business Mailing Address
First Line	:	3555 WILLOW LAKE BLVD
Second Line	:	SUITE 240
City	:	SAINT PAUL
State	:	MN
Zip	:	55110-5131
Country	:	US
Telephone Number	:	651-770-0110
Fax Number	:	651-770-0134

Provider Business Practice Location Address
First Line	:	3555 WILLOW LAKE BLVD
Second Line	:	SUITE 240
City	:	VADNAIS HEIGHTS
State	:	MN
Zip	:	55110-5131
Country	:	US
Telephone Number	:	651-770-0110
Fax Number	:	651-770-0134

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/25/2007
Last Update Date	:	10/02/2013

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Directions to “ DR. MARGARET A COLLINS M.D.” Practice Location

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