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NPI Code Detail

MEDICARE: MICHAEL P COLLINS MD

MEDICARE: MICHAEL P COLLINS MD
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
1208G00000XThoracic Surgery (Cardiothoracic Vascular Surgery) Physician162213-1205UT

General Provider Information

NPI Number : 1366577256
Entity Type Code : Individual
Provider Name (Legal Business Name) : MICHAEL P COLLINS MD
Provider Business Mailing Address
First Line : PO BOX 27128
Second Line :
City : SALT LAKE CITY
State : UT
Zip : 84127-0128
Country : US
Telephone Number : 801-507-3600
Fax Number :
Provider Business Practice Location Address
First Line : 5169 S COTTONWOOD ST
Second Line : STE 600
City : SALT LAKE CITY
State : UT
Zip : 84107-6771
Country : US
Telephone Number : 801-507-3600
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/22/2007
Last Update Date : 10/16/2012

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