Provider Demographics
NPI:1235230913
Name:COLLINS, AARON MATTHEW (MD)
Entity Type:Individual
Prefix:
First Name:AARON
Middle Name:MATTHEW
Last Name:COLLINS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 INDEPENDENCE PT
Mailing Address - Street 2:STE 212
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29615-4545
Mailing Address - Country:US
Mailing Address - Phone:864-797-6306
Mailing Address - Fax:
Practice Address - Street 1:701 GROVE RD
Practice Address - Street 2:ER ADMINISTRATION
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29605-5611
Practice Address - Country:US
Practice Address - Phone:864-455-6372
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-26
Last Update Date:2013-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC28625207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCP00385806OtherRAILROAD MEDICARE
SC57-6007863OtherBCBS OF SOUTH CAROLINA
SC57-6007863OtherCHAMPUS-TRICARE
SC286256Medicaid
SC286256Medicaid
SCI25316-3415Medicare UPIN
SCI25316-3417Medicare PIN
SCI25316-3414Medicare PIN