Provider Demographics
NPI:1336123108
Name:COLLIER, ANNETTE KAY (MD)
Entity Type:Individual
Prefix:
First Name:ANNETTE
Middle Name:KAY
Last Name:COLLIER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30000 E RIVER RD
Mailing Address - Street 2:
Mailing Address - City:PERRYSBURG
Mailing Address - State:OH
Mailing Address - Zip Code:43551-3429
Mailing Address - Country:US
Mailing Address - Phone:419-861-5460
Mailing Address - Fax:419-861-7611
Practice Address - Street 1:580 CRAIG DR
Practice Address - Street 2:PMB 182 #8
Practice Address - City:PERRYSBURG
Practice Address - State:OH
Practice Address - Zip Code:43551-1778
Practice Address - Country:US
Practice Address - Phone:419-861-5460
Practice Address - Fax:419-861-7611
Is Sole Proprietor?:No
Enumeration Date:2005-12-05
Last Update Date:2022-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35057926207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH110218013OtherRAILROAD MEDICARE
OH01101OtherPARAMOUNT
OH0843949Medicaid
OH000000195550OtherANTHEM
OH0843949Medicaid