Provider Demographics
NPI:1649392853
Name:COLLINS, MATTHEW ALAN (MD)
Entity Type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:ALAN
Last Name:COLLINS
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:275 BETHESDA DR
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27834-7217
Mailing Address - Country:US
Mailing Address - Phone:252-752-5077
Mailing Address - Fax:252-752-9544
Practice Address - Street 1:275 BETHESDA DR
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:NC
Practice Address - Zip Code:27834-7217
Practice Address - Country:US
Practice Address - Phone:252-752-5077
Practice Address - Fax:252-752-9544
Is Sole Proprietor?:No
Enumeration Date:2007-04-06
Last Update Date:2021-05-13
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NC2011-00299208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCNC1464AMedicare PIN