Provider Demographics
NPI:1003896481
Name:COLLIER, DON U (DO)
Entity Type:Individual
Prefix:
First Name:DON
Middle Name:U
Last Name:COLLIER
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13450 E 12 MILE RD
Mailing Address - Street 2:
Mailing Address - City:WARREN
Mailing Address - State:MI
Mailing Address - Zip Code:48088-3671
Mailing Address - Country:US
Mailing Address - Phone:586-759-5525
Mailing Address - Fax:586-759-4765
Practice Address - Street 1:13450 E 12 MILE RD
Practice Address - Street 2:
Practice Address - City:WARREN
Practice Address - State:MI
Practice Address - Zip Code:48088-3671
Practice Address - Country:US
Practice Address - Phone:586-759-5525
Practice Address - Fax:586-759-4765
Is Sole Proprietor?:No
Enumeration Date:2006-01-20
Last Update Date:2008-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIDC005127207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1414370Medicaid
MIP56560001Medicare PIN
MI1414370Medicaid