Provider Demographics
NPI:1831117324
Name:COLVIN, ANTHONY D (MD)
Entity Type:Individual
Prefix:
First Name:ANTHONY
Middle Name:D
Last Name:COLVIN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:300 BILLINGSLEY ROAD, SUITE 200
Mailing Address - Street 2:CAROLINA DIGESTIVE HEALTH ASSOCIATES, PA
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28211-1084
Mailing Address - Country:US
Mailing Address - Phone:704-372-7974
Mailing Address - Fax:704-372-5166
Practice Address - Street 1:1663 CAMPUS PARK DRIVE, SUITE D
Practice Address - Street 2:CAROLINA DIGESTIVE HEALTH ASSOCIATES, PA
Practice Address - City:MONROE
Practice Address - State:NC
Practice Address - Zip Code:28212-5581
Practice Address - Country:US
Practice Address - Phone:704-291-2488
Practice Address - Fax:704-291-7533
Is Sole Proprietor?:No
Enumeration Date:2006-07-17
Last Update Date:2010-10-27
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NC9400451207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC891029AMedicaid
NC89129AMedicaid
NC89129AMedicaid
NC2204941CMedicare Oscar/Certification
NC891029AMedicaid