Provider Demographics
NPI:1619974813
Name:COLLINS, ANDREW STUART (MD)
Entity Type:Individual
Prefix:
First Name:ANDREW
Middle Name:STUART
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 1:626 BERKMAR CIR
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22901-1464
Mailing Address - Country:US
Mailing Address - Phone:434-295-3227
Mailing Address - Fax:434-295-9527
Practice Address - Street 1:626 BERKMAR CIR
Practice Address - Street 2:
Practice Address - City:CHARLOTTESVILLE
Practice Address - State:VA
Practice Address - Zip Code:22901-1464
Practice Address - Country:US
Practice Address - Phone:434-295-3227
Practice Address - Fax:434-295-9527
Is Sole Proprietor?:No
Enumeration Date:2005-07-01
Last Update Date:2010-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101231246207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAP00261018OtherPALMETTO RAILROAD
VA009999477Medicaid
VA278918OtherANTHEM
VA213641OtherSOUTHERN HEALTH
VA278918OtherANTHEM
VA009999477Medicaid