Provider Demographics
NPI:1659473460
Name:COLLINS, DIANA B (MD)
Entity Type:Individual
Prefix:DR
First Name:DIANA
Middle Name:B
Last Name:COLLINS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:PO BOX 14883
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27415-4883
Mailing Address - Country:US
Mailing Address - Phone:336-268-3380
Mailing Address - Fax:336-268-3399
Practice Address - Street 1:301 E WENDOVER AVE
Practice Address - Street 2:SUITE 300
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27401-1230
Practice Address - Country:US
Practice Address - Phone:336-268-3380
Practice Address - Fax:336-268-3399
Is Sole Proprietor?:No
Enumeration Date:2006-09-02
Last Update Date:2008-02-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC33802207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC23793OtherBCBS OF NC
NC7923793Medicaid
NC1182OtherPARTNERS MEDICARE
NCB2989OtherMEDCOST
NC2162894BMedicare PIN
E94015Medicare UPIN