Provider Demographics
NPI:1669438933
Name:COLLINS, TERRANCE A (MD)
Entity Type:Individual
Prefix:
First Name:TERRANCE
Middle Name:A
Last Name:COLLINS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:106 IRVING ST NW
Mailing Address - Street 2:SUITE 2700N
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20010-2927
Mailing Address - Country:US
Mailing Address - Phone:202-877-5800
Mailing Address - Fax:202-291-0512
Practice Address - Street 1:2670 CRAIN HWY
Practice Address - Street 2:SUITE 300
Practice Address - City:WALDORF
Practice Address - State:MD
Practice Address - Zip Code:20601-2806
Practice Address - Country:US
Practice Address - Phone:301-632-5750
Practice Address - Fax:301-632-5755
Is Sole Proprietor?:No
Enumeration Date:2006-04-25
Last Update Date:2014-09-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MDD0044916207RC0000X
DCMD20347207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD608858-01OtherBCBS
MDF68268Medicare UPIN
MDKP0625LLMedicare ID - Type Unspecified