Provider Demographics
NPI:1679522122
Name:COLLINS, DONALD S (MD)
Entity Type:Individual
Prefix:
First Name:DONALD
Middle Name:S
Last Name:COLLINS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:4745 OGLETOWN STANTON RD
Mailing Address - Street 2:MAP 1, SUITE 220
Mailing Address - City:NEWARK
Mailing Address - State:DE
Mailing Address - Zip Code:19713-2067
Mailing Address - Country:US
Mailing Address - Phone:302-368-5515
Mailing Address - Fax:302-366-1240
Practice Address - Street 1:4745 OGLETOWN STANTON RD
Practice Address - Street 2:MAP 1, SUITE 220
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19713-2067
Practice Address - Country:US
Practice Address - Phone:302-368-5515
Practice Address - Fax:302-366-1240
Is Sole Proprietor?:No
Enumeration Date:2006-05-10
Last Update Date:2008-04-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
DEC10007201207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
2364484000OtherAMERIHEALTH/KEYSTONE
257404OtherCOVENTRY
5905713OtherCIGNA
DE1000032485Medicaid
2124822OtherMAMSI
4248162OtherAETNA/USHC
DE1000033567Medicaid
1689286OtherINDEPENDENCE BCBS
257404OtherCOVENTRY
P00173654Medicare ID - Type UnspecifiedPALMETTO BGA MEDICARE
DE015969P26Medicare PIN