Provider Demographics
NPI:1568796662
Name:COLLAZO, ANELA MICHELLE (PA-C)
Entity Type:Individual
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First Name:ANELA
Middle Name:MICHELLE
Last Name:COLLAZO
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Gender:F
Credentials:PA-C
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Mailing Address - Street 1:535 OLD WESTMINSTER PIKE
Mailing Address - Street 2:SUITE 102
Mailing Address - City:WESTMINSTER
Mailing Address - State:MD
Mailing Address - Zip Code:21157-6267
Mailing Address - Country:US
Mailing Address - Phone:410-871-6864
Mailing Address - Fax:410-871-6226
Practice Address - Street 1:844 WASHINGTON RD
Practice Address - Street 2:SUITE 102
Practice Address - City:WESTMINSTER
Practice Address - State:MD
Practice Address - Zip Code:21157-6664
Practice Address - Country:US
Practice Address - Phone:410-871-0088
Practice Address - Fax:410-871-0083
Is Sole Proprietor?:No
Enumeration Date:2009-09-23
Last Update Date:2015-10-06
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Provider Licenses
StateLicense IDTaxonomies
MDC0003833363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical