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NPI Code Detail

MEDICARE: BRIDGET COLLINS, MD, LLC

MEDICARE: BRIDGET COLLINS, MD, LLC
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
1207Q00000XFamily Medicine PhysicianMD-12374HI

General Provider Information

NPI Number : 1033627930
Entity Type Code : Organization
Provider Name (Legal Business Name) : BRIDGET COLLINS, MD, LLC
Provider Business Mailing Address
First Line : 5903 KIINANI PL
Second Line :
City : KAPAA
State : HI
Zip : 96746-9707
Country : US
Telephone Number : 808-212-9867
Fax Number :
Provider Business Practice Location Address
First Line : 3175 ELUA ST STE C
Second Line :
City : LIHUE
State : HI
Zip : 96766-1203
Country : US
Telephone Number : 808-212-9867
Fax Number : 434-333-7504
Authorized Official
Title or Position : OWNER
Name : DR. BRIDGET MAUREEN COLLINS
Credential : MD
Telephone Number : 808-212-9867
Provider Enumeration Date : 01/14/2018
Last Update Date : 04/01/2019

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Directions to “BRIDGET COLLINS, MD, LLC ” Practice Location

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