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1386633238

NPI Code Detail

MEDICARE: DR. MICHAEL KEVIN COLLINS MD

MEDICARE: DR. MICHAEL KEVIN 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
1	207P00000X	Emergency Medicine Physician	053687	GA
2	207Q00000X	Family Medicine Physician	053687	GA
3	2085R0202X	Diagnostic Radiology Physician	053687	GA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	52068609-003	OTHER	GA	BCBS PROVIDER NUMBER
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1386633238
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MICHAEL KEVIN COLLINS MD

Provider Business Mailing Address
First Line	:	PO BOX 3157
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46206-3157
Country	:	US
Telephone Number	:	770-405-2976
Fax Number	:

Provider Business Practice Location Address
First Line	:	790 CHURCH ST NE STE 400
Second Line	:
City	:	MARIETTA
State	:	GA
Zip	:	30060-8957
Country	:	US
Telephone Number	:	770-405-2976
Fax Number	:

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

Provider Enumeration Date	:	10/13/2005
Last Update Date	:	08/23/2022

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Directions to “ DR. MICHAEL KEVIN COLLINS MD” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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