Provider Demographics
NPI:1437153137
Name:COLLINS, ROBERT G (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:G
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 1:10544 LEE HWY
Mailing Address - Street 2:
Mailing Address - City:FINCASTLE
Mailing Address - State:VA
Mailing Address - Zip Code:24090-4466
Mailing Address - Country:US
Mailing Address - Phone:540-992-5497
Mailing Address - Fax:
Practice Address - Street 1:10544 LEE HWY
Practice Address - Street 2:
Practice Address - City:FINCASTLE
Practice Address - State:VA
Practice Address - Zip Code:24090-4466
Practice Address - Country:US
Practice Address - Phone:540-992-5497
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-06-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101048046208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA4237326OtherAETNA
VA8916298002OtherCIGNA
VA236863OtherMAMSI
VA54088505602OtherJOHN DEERE
VA281056OtherANTHEM
VA54088505602OtherJOHN DEERE