MEDICARE: DR. MICHAEL PETER 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	207V00000X	Obstetrics & Gynecology Physician	4301028725	MI

General Provider Information

NPI Number	:	1962452821
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MICHAEL PETER COLLINS MD

Provider Business Mailing Address
First Line	:	2325 GARFIELD RD N
Second Line	:	GRAND TRAVERSE COUNTY HEALTH DEPARTME
City	:	TRAVERSE CITY
State	:	MI
Zip	:	49686-5127
Country	:	US
Telephone Number	:	231-922-2747
Fax Number	:	231-922-2719

Provider Business Practice Location Address
First Line	:	2325 GARFIELD RD N
Second Line	:	GRAND TRAVERSE COUNTY HEALTH DEPARTMENT
City	:	TRAVERSE CITY
State	:	MI
Zip	:	49686-5127
Country	:	US
Telephone Number	:	231-922-2747
Fax Number	:	231-922-2719

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

Provider Enumeration Date	:	05/11/2006
Last Update Date	:	02/15/2012

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