Provider Demographics
NPI:1023064896
Name:COLLINS, TIMOTHY S (MD)
Entity type:Individual
Prefix:DR
First Name:TIMOTHY
Middle Name:S
Last Name:COLLINS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 60516
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28260-0516
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3333 SILAS CREEK PKWY
Practice Address - Street 2:
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27103-3013
Practice Address - Country:US
Practice Address - Phone:336-277-8800
Practice Address - Fax:336-277-8850
Is Sole Proprietor?:No
Enumeration Date:2006-05-25
Last Update Date:2024-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC9700904207R00000X, 207RH0003X, 207RX0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1023064896Medicaid
806520OtherPARTNERS
P00337924OtherRAILROAD MEDICARE
NC1398COtherBCBS
188800OtherMEDCOST
NC891080XMedicaid
VA010291046Medicaid
3363840OtherCIGNA HEALTHCARE
2527191OtherUNITED HEALTHCARE
NC1398COtherBCBS
P00337924OtherRAILROAD MEDICARE
2527191OtherUNITED HEALTHCARE