Provider Demographics
NPI:1023275229
Name:COLLINS, SARA DEREATH (MD)
Entity type:Individual
Prefix:DR
First Name:SARA
Middle Name:DEREATH
Last Name:COLLINS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:16900 SCIENCE DR STE 200
Mailing Address - Street 2:
Mailing Address - City:BOWIE
Mailing Address - State:MD
Mailing Address - Zip Code:20715-4425
Mailing Address - Country:US
Mailing Address - Phone:410-573-9805
Mailing Address - Fax:410-573-9806
Practice Address - Street 1:16900 SCIENCE DR STE 200
Practice Address - Street 2:
Practice Address - City:BOWIE
Practice Address - State:MD
Practice Address - Zip Code:20715-4425
Practice Address - Country:US
Practice Address - Phone:410-573-9805
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-05-16
Last Update Date:2022-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCMD36271207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease