Provider Demographics
NPI:1497750905
Name:COLLINS, HEATHER (DO)
Entity Type:Individual
Prefix:DR
First Name:HEATHER
Middle Name:
Last Name:COLLINS
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1650 HUNTINGDON PIKE
Mailing Address - Street 2:SUITE 256
Mailing Address - City:MEADOWBROOK
Mailing Address - State:PA
Mailing Address - Zip Code:19046-8004
Mailing Address - Country:US
Mailing Address - Phone:215-938-1070
Mailing Address - Fax:215-938-0250
Practice Address - Street 1:1650 HUNTINGDON PIKE
Practice Address - Street 2:SUITE 256
Practice Address - City:MEADOWBROOK
Practice Address - State:PA
Practice Address - Zip Code:19046-8004
Practice Address - Country:US
Practice Address - Phone:215-938-1070
Practice Address - Fax:215-938-0250
Is Sole Proprietor?:No
Enumeration Date:2005-06-21
Last Update Date:2012-12-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAOS010435L207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA048741Medicare PIN