Provider Demographics
NPI:1437236833
Name:COLLINS, MARGARET MARY (PAC)
Entity Type:Individual
Prefix:MS
First Name:MARGARET
Middle Name:MARY
Last Name:COLLINS
Suffix:
Gender:F
Credentials:PAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2101 E JEFFERSON ST
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20852-4908
Mailing Address - Country:US
Mailing Address - Phone:301-816-2414
Mailing Address - Fax:301-388-1740
Practice Address - Street 1:6196 ARLINGTON BLVD
Practice Address - Street 2:
Practice Address - City:FALLS CHURCH
Practice Address - State:VA
Practice Address - Zip Code:22044-2902
Practice Address - Country:US
Practice Address - Phone:703-237-3446
Practice Address - Fax:703-237-9355
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2012-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0110840576363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
S06770Medicare UPIN
007653M92Medicare ID - Type Unspecified